HEALTHY CITIES ILLAWARRA Ten Years On
1987 - 1997
Author Dr Pat Mowbray
with contributions from
Tony Mills Penny Lumb Linda Brazier Katherine van Weerdenburg
Healthy Cities Illawarra Inc. is funded by the NSW Department of Health and the Illawarra Area Health Service
HEALTHY CITIES ILLAWARRA Ten Years On 1987 - 1997
Contents
Page
Acknowledgement ...... 1
Introduction ...... 2
A Case Study of the Illawarra ...... 8
The First Three Years ...... 10
The Process and Reality of Community Development ...... 13
Working with Disadvantaged Communities ...... 16
Task Forces ...... 22
Spreading the Message across Australia and Overseas ...... 30
Working with Key Organisations ...... 32
Healthy Cities Shoalhaven ...... 36
Supporting Communities since 1990 ...... 44
Needs Assessments and Evaluations 1991-1996 ...... 50
Working in Partnership - Healthy Cities Illawarra and the Illawarra Safe Communities Program ...... 53
Conclusion ...... 58
Management Committee and Staff ...... 59
Acknowledgements
The Healthy Cities concept is based upon collaboration and partnerships between various sectors. Healthy Cities Illawarra necessarily has a long list of partners and supporters who have co-operated and contributed to the past ten years achievements.
The following people and organisations have all been integral to the development and success of Healthy Cities Illawarra:
• NSW Health Department
• Illawarra Area Health Service - Health Promotion Unit Illawarra Public Health Unit Board, management and staff Community Health Services
• Local government councils of Wollongong, Shellharbour, Kiama and Shoalhaven
• State and Federal Members of Parliament
• Local media
• Commonwealth Department of Health and Family Services
• Roads and Traffic Authority
• World Health Organisation
• Other businesses, service providers and sponsors who have supported various projects.
A special acknowledgement to the backbone of the organisation - those volunteers who have served on the Management Committee, Council of Reference and Task Forces over the years. Also to the past and current staff who have given beyond the call of duty because they believe there is a better way.
Thank you all.
Healthy Cities Illawarra Incorporated 49 Kembla Street, Wollongong, NSW , Australia 2500 Phone: 02 42265000 Fax: 02 42265339 International + 61 Internet: http://www.healthycitiesill.org.au
HEALTHY CITIES ILLAWARRA Ten Years On
Introduction
In early 1987, the Australian Community Health Association with funding from the Commonwealth Department of Community Services and Health sponsored a three year Healthy Cities pilot project. This was the result of members from both organisations attending conferences in Europe, North America and Canada organised by the World Health Organisation (WHO). These conferences reflected the growing concern regarding the health of the planet and its peoples and the necessity for all to work together to achieve Health For All. This concern was expressed in a commitment to primary health care as far back as 1978 at Alma Ata and the identification of Health For All targets from 1980-84. It culminated in the development of the Ottawa Charter for Health Promotion in 1986 out of which the Healthy City movement was born. It was designed to implement the Charter at a local level.
The Illawarra region together with Canberra (ACT) and Noarlunga (SA) was fortunate to successfully submit for one of the three $60,000 each available grants.
Illawarra is on the south coast of New South Wales. It was chosen because of the mix of urban to rural population, its heavy industrial base, high ethnic population, high unemployment and low average income and because of the growing partnership between the recently established Illawarra Area Health Service and the University of Wollongong. It is also an area of great natural beauty. Initially the project involved the three local governments of Wollongong, Shellharbour and Kiama (combined population 230,000) but has since included the Shoalhaven (population 70,000).
Thus the Illawarra became part of the Australian Healthy Cities movement. As it was established shortly after the initiation of the movement in Europe, there was a sense of the unknown and very much a "flying by the seat of your pants attitude". While we now know a lot more about how to establish and support a Healthy City, Community, Town, Village or Island, I still believe that something of this pioneering spirit and willingness to take risks is essential to the success of individual Healthy Cities projects, as each project differs in its approach and priorities, sometimes enormously so.
There are now some 2,000 Healthy Cities, Communities, Towns, Villages and Islands throughout the world. The movement is still growing rapidly, particularly after the establishment of a Healthy Cities office in every regional centre of the WHO.
This past twelve months we have welcomed five new Healthy Cities in NSW - Albury-Wodonga, Temora, Port Macquarie, Healthy Villages Blue Mountains and Hawkesbury-Windsor. It has also seen the establishment of the NSW Healthy Cities Liaison Group formed in conjunction with the WHO Regional Training and Development Centre at the University of NSW.
There has been a growing awareness of the increasing threat to the world environment and the necessity to harness the community and the economy to ensure that the way forward is supportive of health rather than leading to its ongoing deterioration. At a local level, work has commenced with Kiama Council with a Municipal Health Plan in a visionary and strategic planning process, to bring together the environment, economy and the community for better health and a better environment.
At a global level, Healthy Cities Illawarra is one of the initiators of the Global Ecohealth Network (www.vianet.net.au/ eco-heal). The Network aims to bring together individuals and organisations who are concerned about and want to tackle the worldwide threat to public health caused by the deteriorating world environment.
The next ten years will be crucial to the future health of the human race.
HEALTHY CITIES ILLAWARRA
CHARTER
1. Every individual has an equal right to his or her optimum level of health.
2. Health is the responsibility of everyone in the community.
3. We therefore commit ourselves to action at a local level to improve the health of the people of the Illawarra by:
• Working together on a co-operative basis
• Supporting community action
• Developing personal skills and worth
• Ensuring effective health advocacy
• Encouraging health promotion and community care
• Protecting and enhancing the physical environment
• Recognising the right of the individual to work and contribute
• Developing local policy and actions to establish a social, economic and physical environment conducive to health.
AIMS
1. To involve government agencies and non-government organisations in the development of Healthy Public Policy and actions by acting as a catalyst for change.
2. To increase community awareness at every level of the many factors which affect health and the necessary elements of a Healthy City.
3. To achieve wide community involvement through intersectoral collaboration and community participation recognising the special needs of those most disadvantaged.
4. To act as a community advocate and facilitate supportive community action.
5. To assist in the re-orientation of services towards community need.
6. To facilitate the creation of a social, economic and physical environment in the Illawarra which is supportive to health.
7. To develop links and a mutually supportive relationship with participating Healthy Cities and new and intending Healthy Cities.
Guiding Principles
Four Beacons
The mirror of "Health for All" is "All for Health". The path to achieving this aim is thorny but rewarding, full of minefields but also full of surprises. In Australia there is a tendency to label community organisations full of "good" people doing good things as opposed to more formal bureaucratic organisations which are labelled "bad" people doing bad things. Yet there are positive and negative forces in every organisation and indeed in every individual.
How then do we proceed, when our brief is to work with people and organisations at every level, some of whom may be diametrically opposed to each other or whose ele ments seem to negate our task?
This process can never be an easy one.
Four beacons have guided us on our way.
(1) The Ottawa Charter (1)
• Build Healthy Public Policy
• Support Community Action
• Develop Personal Skills
• Create Supportive Environments
• Re-orientate services (not just health services we believe) towards community need.
This charter outlines a total approach which Healthy Cities was designed to implement at a local level. It acts as a constant monitor of progress.
It automatically means that one must grapple with all the difficult factors outlined previously. However it also acts as an inspiration in its totality. In working with the Ottawa Charter one becomes aware of the connections between the five elements - wherever one starts one is drawn inescapably into the other four. In fact we see the five elements as together constituting true community development. Thus we feel everyone has a role and responsibility in the process - not only the grass roots, but every person at every level.
(2) Vision
After all it only takes two persons to share a vision - it does not matter where it comes from as long as it is taken up by others. That shared vision is our second beacon. It helps to diminish differences, encourages innovation, heals past wounds. Vision workshops are a powerful tool to unite disparate groups and individuals.
------(1) W.H.O. Health and Welfare Canada, Canadian Public Health Association (1986), "Ottawa Charter for Health Promotion", W.H.O. Geneva
(3) Human Relationships
The third beacon is the power of human relationships - the shared feelings and trust between people of any age, sex, nationality, colour or faith. Such a network is essential to any project.
(4) The Environment
And the fourth beacon? It is one that many non-Aboriginal people are only now discovering - the environment - a non-verbal communication no less powerful than interpersonal relationships. It is essential for our viable future. No effort by an individual or group to improve their environment is too small, no aim too large.
Students from Keiraville Public School caring for their environment Photo courtesy “Illawarra Mercury”
Some Thoughts on our Experience
Twelve Steps
The following twelve steps have been gained from the experience of working with Healthy Cities Illawarra. However there is no one way - every city, town, village, community or island is different.
1. Involving the wider community
Wherever one starts whether with a municipal health plan, with funding for a single project or with a holistic approach to a whole community, issue a clear invitation to involve the wider community - both organisational and grass roots. This may take the form of a public meeting or a meeting of appropriate groups.
2. Structure
Don't let your wider community go without getting them to name the major problems facing your community before they become your reference committee. Get them to elect a representative management committee and involve them in becoming members of task forces to address the identified problems.
3. Feedback and report writing
Provide reference and management committees and the community, including most importantly power brokers; e.g., politicians, media, etc., with regular feedback of progress and achievements. Publicise yourself!
4. Define your community
Identify your most disadvantaged communities or groups and make a commitment to work with them and support them; e.g., help with information, applications, etc. They will repay you many times and achievements in these areas will give you your greatest satisfaction. Remember trust takes time to develop - start small with something achievable then build on your efforts in the one community over time.
5. Your first major project
Start with something achievable and of wide public interest. You will learn a lot and gain credibility.
6. Work with the traditional health and health-related sectors
For example, Area Health Service, Regional Health Authorities, Public Health Units, Community Health Services and Health Promotion, Local Government, secondary and tertiary educational institutions, Cancer Council, Division of General Practice etc.
This partnership is particularly important when working on national and state priorities; e.g., injury prevention, heart disease, cancer, etc.
7. Give everyone credit for their efforts
Be sure to mention all parties involved in your verbal, formal and informal reports. Start from the present - don't criticise past performance. Look for the positive and be prepared to work with everyone.
8. Funding
Try to ensure that there is adequate funding for at least a part-time or full-time project officer with administrative backup and some money for project implementation. We believe the only time this may not apply would be in a small town or if proceeding on a project by project basis. Once established, seek funding and grants from other sources. Keep your funding source particularly well informed. Key sources are health and local government. Other sources could be other government departments both State and Federal, private business and industry, Area Assistance Scheme, Department of Employment, Education and Training, universities etc. Be prepared to use university undergraduate and graduate students to assist in projects.
9. Incorporate
This will protect your management committee and enable you to obtain non-government funding. It establishes you as a recognisable identity and enables you to sponsor and assist other non-government organisations.
10. Check your problem diagnosis
This can be done by such things as surveys, community consultation, undertaking a social health atlas, etc.
11. Evaluate your efforts both internally and externally
Record what have you achieved, what new directions you should take, what do others think of your efforts and have they changed their attitudes and behaviour to working more co-operatively in implementing the principles behind the Healthy Cities movement.
12. Be prepared to help others starting out
Join the Australian and world-wide network of Healthy Cities, Shires, Towns, Villages, Communities and Islands. You learn just as much as you give!
A Case Study of the Illawarra
Early Days ..... Getting Started
As part of the submission process and acting on rather meagre information from World Health (see Appendix 1), a small group of people from Wollongong University, including Professor Dennis Calvert and Associate Professor Christine Ewan, and the Illawarra Area Health Service (IAHS), including Drs. Peter Brennan and Pat Mowbray, with the support of the Board, agreed to invite to a public meeting approximately 100 community groups, business, unions, industry, government departments, local government, churches, politicians and media representing the main interests in the Illawarra. The letters asked for their help in bringing Health for All to the Illawarra. Attached was a summary from the WHO "Health for All" series 1-8 (2) which included the following:
"Health for all cannot be achieved by the health sector, alone, nor can it be achieved without community acceptance and participation. Government, institutions, members of the health professions, as well as agencies involved in health and development will therefore have to take measures to enlighten the public in health matters so they can readily participate. As part of community participation political, social and community leaders, organisations, industry, labour, relevant professions and the media must be involved. Co-ordination between sectors such as education, agriculture, housing, welfare becomes essential and an acceptable level of economic and social development achieved. Policies must be formulated, problems identified, a plan of action should be followed, objectives should be set and attained and implementation monitored and evaluated."
Thus we gave a clear message that we needed help and the project belonged to the whole community.
Formation of Council of Reference, Management Committees and Task Forces
Approximately seventy people attended the first public meeting and rather to our surprise seemed to readily grasp and even support the concept. At the conclusion of the meeting they were asked to go back to those they represented to gain their formal support and to return to a second meeting prepared to identify the major problems facing the Illawarra with task forces to be formed to assist in their solution.
At this second meeting those attending became the Reference Committee and a smaller Management Committee was elected with representatives from the three local government areas, Area Health Service, Wollongong University, Department of School Education and community.
The present management committee meets monthly and now includes the Director of the Public Health Unit as well as the Directors of Community Health and Health Promotion (the latter two as observers); local government representation includes the Mayor of Kiama, Deputy Mayor of Shellharbour and a Councillor from Wollongong City Council; a representative from the Department of School Education, University of Wollongong, two community representatives and the Project Manager. Healthy Cities Shoalhaven has its own Reference and Management Committees.
------(2) W.H.O. Global Strategy for Health for All by the Year 2000, W.H.O. Geneva
In an effort to gain early "runs on the board" task forces were quickly formed to address the identified problems. These task forces are still in existence with the exception of Health and Employment and Heart Health and Nutrition and consist of: Transport and Environment (formerly Pollution); AIDS; Aged; Child Injury Prevention and the QUIT Action Committee - a joint undertaking with Kembla House Drug and Alcohol Services.
Charter
The Council of Reference initially met three times a year but now only meets once a year. In the course of their meetings they developed our Charter - a layman's version of the Ottawa Charter which they have all signed (see page 3). Many of them joined the task forces and have also been called on for help and support of specific community projects. Such a Council of Reference is crucial to any project.
Bob Harrison, MP, Graham Harris, Tony Mills and Councillor Joyce Wheatley Tree Planting at Lions Park, Kiama to commemorate World Health Day, 7 April, 1996 Photo courtesy “Illawarra Mercury”
The First Three Years
Appointment of Project Officer and Our First Community Project
With the arrival of the grant from the Commonwealth in July 1987, a Project Officer, Mr. Tom Halloran, was appointed for three years. His main role was to record the progress of the project and to ensure that the proper evaluation process was in place from the beginning.
Because of media publicity given to the commencement of the project it was not long before we were contacted by the broader community. This was from the Bellambi Neighbourhood Centre whose Co- ordinator, Robyn Alderton rang to say that the Bellambi community was very frustrated about the bad press it was receiving from the local media. Bellambi is a large public housing area in the northern suburbs of Wollongong with high numbers of single parents, high unemployment and low socio-economic index. It is, on every count one of the most disadvantaged areas in the Illawarra. It does however, have a wonderful Neighbourhood Centre which was largely trying to deal with the "grassroots" community's problems on their own.
Acting on an article we had read by Trevor Hancock, on the conduct of a Vision Workshop (3), Tom Halloran and Pat Mowbray attended an evening meeting at the Neighbourhood Centre. It was a wet, windy, winter's night and there was some disappointment with the attendance of some ten adults and six children. However, Tom proceeded to read the suggested script, and the children were asked to draw their vision of Bellambi in the year 2010.
To our great surprise it was not big and grandiose dreams that emerged - rather simple things - playground equipment for the children (there was none in the Housing Department area), more trees, cleaner air, improved lighting in the streets, a bus shelter shed at the main bus stop, more child health services and services generally, no contamination of their swimming pool by the sewerage works next door, and future jobs for their children.
We then asked them who could help bring about their dreams and interestingly they named particular people in local government and government departments and included the local general medical practitioner. Obviously they had the run around from others not named. So we brought together these people they had named along with their heads of department and the people of Bellambi in a seminar of some forty people. It was a very moving occasion. The head of the Housing Department immediately promised $150,000 for landscaping and playground equipment, the Joint Coal Board provided funding for a bus shelter, the Area Health Service another Community Nurse, the Council to really investigate the contamination of the swimming pool and assist with landscaping.
We will not proceed with the story of Bellambi at this stage - this will be covered in the Process of Community Development Section - suffice to say that it was a long hard road and we learnt much in the process and it is still going on!
------(3) Hancock, T (1988), Healthy Toronto - A Vision of a Healthy City, Healthy Cities Concepts and Visions - A Resource for W.H.O. Healthy Cities Project Department of Community Health
Healthy Cities Grows
The next major event was a stroke of good fortune in the shape of Mr. Brian Stewart who became our Project Manager until 1996 when he retired. Brian had been with the Drug and Alcohol Authority which was restructured, so he elected to join Healthy Cities Illawarra in Wollongong. He came with a background in journalism and experience in politics and thus we acquired Brian's salary and motor vehicle, and a part-time secretary/administrative officer, Barbara Boniface. Brian lost no time in establishing our regular three monthly report which was sent to some 400 persons in the Illawarra, Australia and overseas including politicians, other Australian Healthy Cities, media, all funding bodies and general practitioners. This keeps everyone informed of progress and continues to this day. It is probably our best effort at publicising ourselves and seems popular with all concerned as it is an ongoing record of actions and achievements.
Within its first three years the project expanded considerably. During this time Tony Mills was appointed as Assistant Manager and additional secretarial assistance was engaged two days a week, initially by Karin Allen and later Karen Jones.
Healthy Cities Awards
These were instituted in 1988 on an annual basis to recognise the efforts of schools, organisations and individuals in improving the overall health of the community. They now include Safe Community and Health Promoting School awards, including a prize for the high school and primary school which overall comes closest to fulfilling all the principles of Healthy Cities. Approximately 100 certificates with a few prizes are distributed each year at a moving and inspirational ceremony which incorporates an indigenous peoples, school or ethnic cultural event from the local community. They have been held at the BHP Conference Centre and St Mary's College at no charge.
School children attending Healthy Cities Award Presentation - November 1995 Photo courtesy Illawarra Area Health Service
Marketing
Healthy Cities t-shirts, balloons, sun hats, fridge magnets, environmentally friendly shopping bags and stickers have proved extremely popular and are often used as prizes for community events.
1st National Conference 12-14 February, 1990
This conference was held at the Performing Arts Centre in Wollongong and attracted some 260 delegates. It was organised by Healthy Cities Australia and the three pilot Australian Healthy Cities. Dr John Ashton from Liverpool Healthy Cities was the keynote speaker. Members of the Council of Reference, Management Committee and staff of Healthy Cities presented twelve papers and nine workshops and co-ordinated three special interest groups. Ethnic health workers provided an ethnic arts and craft display and the Nutrition Task Force provided healthy lunches and a nutrition display. Participants in the Conference also had the opportunity to visit six sites indicative of Healthy Cities activities and attend a reception hosted by Wollongong City Council.
As a result of attendance by the Minister for Health at the Conference, with support from NSW Department of Health a $100,000 non-government organisation grant was given to Healthy Cities Illawarra. This was later negotiated by our Project Manager to be ongoing.
Contact with Other Healthy Cities
Visits and assistance were made to intending Healthy Cities including Blacktown, Orange, Bathurst and Albury in NSW, Hobart, Launceston and Devenport in Tasmania.
Healthy Cities Illawarra continued regular valuable contact with Healthy Cities Australia, Canberra and Noarlunga. This involved teleconferences, visits and seminars.
Project Review
At the conclusion of three pilot years, the Project Officer, Tom Halloran, assisted by members of the Management Committee, produced a Report entitled "Healthy Cities Illawarra - A Report on the Pilot Project, July 1987-1990" The Illawarra Regional Information Service also conducted a three part review when the Management Committee was interviewed with the intention of clarifying aims and objectives of the project, the second part was a random telephone survey of 400 people as to their awareness of Healthy Cities (approximately one third were aware of the project). The third part was a survey of the Council of Reference as to awareness, involvement and approval of the project. Overall the review indicated success in meeting aims and objectives of the project and gave us encouragement to continue on our path.
The Process and Reality of Community Development
Some Thoughts on Community Development
Most people who involve themselves in community development and participation will tell you how difficult it is to achieve. Sociologists will decry most efforts at community development as coming into the lower half of Arnstein's ladder of citizen participation which, starting from the least desirable and working to the most desirable, is as follows:
Manipulation Therapy Informing Consultation Placation Partnership Delegated power Citizen control
The truth is that none of us is perfect or ever will be. No organisation or community is above reproach or if it is one minute, it is not the next. For organisations and communities are made up of human beings with all their faults and idiosyncrasies, their changes of mind, behaviour and emotion. Thus everyone involved in community development including the community, have stood on all rungs of Arnstein's ladder in order to achieve their aims.
At the same time the community continues to confound us by taking some of our worst efforts at community development, shaking them and salvaging the best bits to achieve ultimate citizen control.
The experience of Healthy Cities Illawarra has taught us that it really doesn't matter where a good idea originates from, who initially runs with it and develops it, provided that it is eventually taken up by the people necessary to its implementation. In most cases, this will necessitate not only the involvement of grass roots community but of many other sectors as well, a mix that can constantly change as necessary. Gone are the days when any of us can divorce ourselves from the rest of the community or responsibility for that community - we are all members of that community irrespective of our position or stature. Of course by involving "All for Health" we necessarily let in the imperfect and heaven knows where we are on Arnstein's ladder - probably all different levels at once!!
The community development process described is a constantly changing one, taking advantage of opportunities that arise over time which may not be obvious from the beginning. It incorporates ideas that arise from the grassroots community as well as a more professional task force or environment such as a school. Working in one community over time has the potential to involve the whole community when they and circumstances are ready to be involved. It is in short the Ottawa Charter in action.
Many thousands of people in the Illawarra have been involved in our projects - we thank them for teaching us what community development is all about.
To illustrate this there is no better way than to tell the stories of our most disadvantaged communities and our most ambitious project.
Project Armada
The state of Lake Illawarra was forcibly drawn to the attention of Healthy Cities Management Committee by a series of articles in the local free Advertiser newspaper referring to "Lake Stinkawarra". Various concerned citizens pointed to the deterioration of this body of water beloved by tourists and locals alike and suggested often widely differing solutions.
It was obvious something had to be done. Both the Lake Management Committee and the Lake Authority were endeavouring to bring together the numerous bodies which had authority over the lake and its foreshores together with local government and community representatives - a complex and difficult operation that was taking a great deal of time and effort. We learnt that one of the major causes of the problem was the behaviour of people who polluted the lake and run-off from homes around the lake. Perhaps this was where we could help.
What could we do? We could form a Committee! In one of our most ham fisted attempts at community development, Pat Mowbray rang up a number of retired friends who had nothing better to do, we thought, than save the lake. Our friends disappeared at an alarming rate and soon we were left with almost no-one. However we had done two things correctly - we had included one retired man who actually lived on the lake and we had put a small piece in the paper that the committee had formed. These two things saved us! Our retired community man brought along two others and our piece in the paper attracted two more. Our three retirees combined to distribute through Neighbourhood Watch, and by letter drop, pamphlets on what to do and what not to do to every household around the lake.
We also found out that two local schools were involved with projects to improve the lake foreshores so they were soon incorporated. By now it was Christmas 1988. What to do next?
The first Sydney Harbour Clean-up, organised by Ian Kiernan came to our rescue. We all returned from holidays with the same thought. Why couldn't we do the same? The Rise and Shine Co-ordinator of Wollongong City Council and representatives from Shellharbour Council joined the committee - we were underway!
After an enormous amount of work by Brian Stewart, Barbara Boniface, the Rise and Shine Co-ordinator and the Committee, 132 organisations from the public and private sector participated over one weekend with 2,000 community volunteers ranging from the Australian Navy who sent two helicopters, and manpower, emergency services, local community members, earth moving and haulage contractors. Local schools also participated over a one week period. Over half a million dollars was given in kind and 1,500 tonnes of rubbish were removed including very large items which only the helic opters could have shifted. The Area Health Service provided a complimentary lunch for the Navy.
Many of our community co-ordinators went on to become Honorary Rangers of the lake. The community response heartened the Lake Committee and Authority and assisted in them coming together to form a much more effective Total Catchment Management Committee. Some of the community co-ordinators from the Berkeley Development Association asked Healthy Cities to assist that body establish an environmental enhancement committee which has continued environmental projects around the lake to this day.
Thus we helped to build healthy public policy, supported community action, developed personal skills, created a supportive environment and reoriented the Navy, health, business, industry and the local community to meet community need.
We were quite surprised to see how all elements of the Ottawa Charter seemed to follow inexorably onwards.
Community volunteer with Project Armada - Lake Illawarra Clean Up, June 1989
Working with Disadvantaged Communities
Berkeley Community
Following on the Lake Illawarra clean-up, Brian Stewart called together meetings of the key groups in Berkeley - a disadvantaged suburb with a large housing department area, a high ethnic population and a degraded and vandalised shopping area. As a result Wollongong City Council put pressure on the overseas owner of the shopping centre to improve the centre or sell. It was bought by a much more sympathetic owner, willing to co-operate in its upgrading and beautification. Police provided a service after normal working hours for the first time, the Neighbourhood Centre was successful in gaining funds for a youth worker, the community became involved in tree planting and began to take a pride in their suburb with everyone adding a tile to a community arts sculpture which became the focal point for the shopping centre. Sympathetic landscaping with Australian natives completed the transformation of the central area. Recently Aboriginal, Lebanese and Turkish groups have constructed a rather extraordinary garden near the neighbourhood centre. Healthy Cities also assisted with the obtaining of a general practitioner grant to employ a nutritionist to assist ongoing educational and cooking programs at the Neighbourhood Centre, also with a breakfast program at the high school and a community food garden adjacent to the Neighbourhood Centre, which together with other efforts, won Wollongong City Council the major NSW Keep Australia Beautiful award in 1995. The community food garden is now being used mainly as a training facility in horticultural practices for young people undergoing training through TAFE and employment programs. This year we have taken part with the community in planting an avenue of trees and a directory of youth services available throughout the Wollongong area.
Today when you visit Berkeley you would hardly recognise it from a few years ago. The Berkeley Development Association goes from strength to strength, involving more and more of the community and we continue to attend their meetings. Members of the Association are also part of the Kembla Green Corridor Committee which aims to link Mount Kembla and Cringila with trees and the Budgong Creek Landcare Group which, with Wollongong City Council, has recently produced the first management guide for landcare groups in NSW.
However it has not all been plain sailing. Only eighteen months ago the Senior Citizens Centre was deliberately burnt down. The work goes on!
Bellambi Community
Following on the improvements previously mentioned Brian Stewart and Wollongong City Council gained further support from Heggies, a local haulage company, the Bellambi Surf Life Saving Club and Holy Spirit College to assist the community in the beautification of Bellambi. A regular Bellambi Interagency meeting was also convened to discuss recurrent problems in the area, knowledge of services and more active intervention by the various agencies. However, the new playground equipment was vandalised and torrential rain destroyed many of the landscaping improvements. A Healthy Cities initiated conference on unemployment in the area resulted in only one extra light industry opening in the area. The head of the Housing Department changed and no new funding seemed to be available. The optimistic mood faltered.
Then our new Project Officer, Tony Mills, started attending and chairing Interagency meetings. Soon it became obvious there was a big need for a breakfast program for children in the area as many children were going without breakfast and sometimes lunch. Sponsors were sought, volunteers recruited, the Beat Police offered to help serve the meals - the project commenced and to this day feeds some forty children daily. Teachers at the local school report much greater interest in learning, particularly in the mornings.
Next a community food garden was planted adjacent to the Neighbourhood Centre and funding was at last obtained to renew the landscaping and playground equipment. A general practice grant was also obtained to employ a project officer to help improve nutrition and exercise levels of the community. Schools, shops, GPs
and community were recruited to carry out this aim. This program has since spread to the whole northern suburbs.
Today the physical appearance of Bellambi has much changed, particularly the foreshores where picnic tables, barbecues, landscaping and a much needed toilet complex have been installed. The swimming pool is now regularly cleaned and emptied by Wollongong City Council. The community has been involved with Wollongong City Council in ongoing environmental improvements including the regeneration of Bellambi Creek and lagoon.
The Neighbourhood Improvement Program by the Department of Housing is well underway. A number of houses have been refurbished and plans for future upgrades have been made with tenants through numerous street meetings.
The wonderful Neighbourhood Centre staff are now much less harried and the media mostly speak well of Bellambi.
Bellambi Neighbourhood Centre Food Garden
Cringila Village Community
The Cringila community of some 3,500 people is located next to the BHP Steel Works. Some 97% of its people come from a non-English speaking background. For a long time we mainly confined our support to the International Community Park Project where 200 trees were being planted for each of the 83 nationalities resident in the area. This site had been rescued by community action from becoming a coalwash dump.
On the park project we worked with, and still continue to do so, the Cringila Community Co-operative, Wollongong Council and various environmental groups. We were also instrumental in gaining the largest urban grant ever given by Greening Australia ($60,000).
Members of the Healthy Cities Nutrition Task Force were alerted to the fact that the dental health of children at Cringila Public School needed improvement through good dental practice and nutrition. We decided to convene a composite committee to involve all appropriate organisations and community groups including local general practitioners, dental health, community and migrant health workers, teachers, the Cringila Co- operative and community groups. We soon realised that to change the habits of the children we would have to change the habits of the whole community and that many of the nutritional problems at least were caused by the various ethnic communities changing from their basically healthy ethnic cuisine to incorporate often the worst of the Australian cuisine. A research student from Wollongong University found that one-third of children were arriving at school without having breakfast.
At the same time the opportunity came about to assist local general medical practitioners to employ a nutritionist through the gaining of a twelve month Commonwealth Government G.P. demonstration grant. With the co-operation of the school, its teachers and students and the privately run school canteen, many innovative programs in both nutrition and dental practice were established and permanently added to the school curriculum and practice. Sandwich and fruit sales soared at the canteen. Breakfast and lunch programs with the Illawarra Steelers, a local football team, with parents and grandparents participating, were a huge success.
Free toothbrushes were distributed and students enthusiastically inspected each other's lunches. Two concerts involving every child in the school were opened by the Director of School Education, the Lord Mayor, Healthy Cities and local general practitioners. The students presented humorous items expounding the principles of good dental practice and nutrition. General practitioners emphasised the same messages to their patients and ran educational groups for their patients at risk. They also approached the local shops to improve their stock. Dietetic students from Wollongong University provided ongoing displays in stores. The nutritionist health worker spoke to many community groups. Thus wherever people went in Cringila, they received the same message.
Evaluation of this project showed many positive changes.
Health Promoting Schools
As part of the field visits of a Healthy Cities seminar held in Wollongong in March, 1993 some participants, including representatives from the Department of School Education, attended Cringila Public School to see what had been achieved. They were so impressed with what they saw that the Regional Healthy Schools (later the Health Promoting Schools Program) was launched at Cringila Public School. This eventually resulted in the IAHS Health Promotion Unit employing a Health Promoting Schools Project Officer (the same nutritionist, Debra Langridge, who was employed at Cringila). This is now a joint program with the IAHS, Department of School Education, Catholic Education and Healthy Cities Illawarra. Ten pilot schools were initially involved together with wide ranging support from the community; e.g., Sydney Water, Environment Protection Authority, NSW Cancer Council, local government etc. Workshops were held on sun protection, the environment and physical activity with many innovative strategies and changes in school practice resulting, including tree planting and shade provision, changes in curric ulum, timetabling and the design and encouragement of use of sunglasses.
Recently, under the direction of Jill Vickery many new schools both in the Illawarra and Shoalhaven have now come into the program with a consequent increase in the number of workshops held. Truly a most successful program.
Futureworld
When Futureworld, the National Centre of Appropriate Technology, was offered the area above the Cringila Community Park as a site by Wollongong City Council, it seemed a natural choice poised as it is between the escarpment and industry. Cringila seemed the ideal place to demonstrate appropriate technology. Two public meetings were held with six interpreters to explain the concept which, after much discussion was enthusiastically received by the people of Cringila. An appropriate technology fair held on the site in 1992 attracted a large attendance and support from Cringila people. We hope that when fully developed Futureworld will bring employment, tourism, economic and environmental benefits to this extraordinary community. After all, it is nothing more than they deserve. For further information re Futureworld, see page 34.
Healthy Food Promotion at Cringila Public School Photo courtesy "Illawarra Mercury"
Port Kembla
Ongoing assistance has been given to the Hill 60 environmental rehabilitation program being carried out by the Hill 60 Land Care Group. This has involved the removal of bitou bush and the planting of indigenous trees and shrubs.
Sponsorship and Assistance to Community Groups
Healthy Cities Illawarra has assisted many individuals and organisations; e.g., the Illawarra Migrant Resource Centre and Lifeline South Coast, with information and assistance with applications for funding. It has also sponsored a number of projects such as the Kiama Domestic Violence Committee and the Shoalhaven Suicide Prevention Network. This part of our work has greatly increased as time has gone on and remains one of our most valuable contacts with the community.
Aboriginal Community
Healthy Cities has been involved with others, particularly Aboriginal Health Workers and the Waminda Women's Health Centre, in the Aboriginal Health Advancement Survey - a comprehensive survey, screen and educational program over time of all Aboriginal people in the Illawarra.
Healthy Cities Illawarra was also part of the Aboriginal and intersectoral committee which organised and ran the Drug and Alcohol Conference, "The Spirit, the Family, the Culture - an Alternative to Drug and Alcohol Abuse", in Nowra in 1993. This was attended by some 80 people, mostly Aboriginal. A video, evaluation report and recommendations of the conference were produced. A further video was sponsored by Healthy Cities Illawarra entitled "I Remember When" - the history and culture of the Aboriginal People of Shoalhaven. This has been made available to schools, business and community. Healthy Cities also contributed to an Aboriginal Youth Drug and Alcohol Camp in Nowra attended by some 80 members of Aboriginal youth in 1995.
At the Jerrinja Aboriginal community at Orient Point we have assisted with the establishment of backyard food gardens, chook houses, shade tree and fruit tree planting, with playground equipment and the development of a playgroup. We have assisted a local general practitioner at Culburra to obtain a G.P. grant to employ a nutritionist to work with the people of this community.
At the Coomaditchie community in Kemblawarra, we assisted with funding and negotiations to obtain a Department of Employment, Education and Training (DEET) grant to rehabilitate the lagoon, construct a walking track that highlights Aboriginal culture, and plant indigenous food plants.
In 1994, Iris McLeod, the Regional Aboriginal Health Co-ordinator and Pat Mowbray were invited by the Eastern Metropolitan Area Health Service in Perth, to speak of their experiences regarding the Healthy Cities approach to community improvements in their area.
Healthy Cities Illawarra also sponsored the first indigenous component of the Illawarra Folk Festival and the Kiama Jazz Festival and have featured Aboriginal music at our annual Healthy Cities Awards.
We encourage and have been involved in a program with ABC Radio Illawarra regarding oral Aboriginal history of the Wollongong area. We are working with Wollongong University to establish an indigenous art collection.
We have recently assisted an Aboriginal Youth Program at Koonawarra, organised by Aboriginal Health Promotion Officer Joyce Donovan to raise self-esteem and promote healthy lifestyle.
Perhaps most importantly we value working with Aboriginal people and have many times supported their struggle. They are a most talented and able people and we admire their strength in the face of enormous difficulties. We believe in an intersectoral approach with all relevant departments and agencies working together with Aboriginal communities to not only improve services and conditions, but also assist in preserving their unique culture and heritage.
Refugee Communities in the Illawarra
There has been involvement with the Illawarra Migrant Resource Centre and Lifeline South Coast on this project over the period 1995-97. Major recommendations are the need for more appropriate counselling services, a more co-ordinated approach amongst service providers and the production of “A Guide to Refugee Communities in the Illawarra: Identity and Needs”.
Folklorika Festival
Healthy Cities Illawarra has been represented on the organising committee of this very successful event since 1996. Over 40 performing groups appeared in this celebration of a multicultural city.
Colin Markham, MP and Nola Roberts at launch of "I Remember When" video February 1995 - Photo courtesy "Illawarra Mercury"
Task Forces
Intersectoral task forces to address the major problems facing the Illawarra have been an essential part of Healthy Cities Illawarra providing an ongoing stable structure and a way of allowing many different organisations and individuals to have input into the project. Many ideas and community development projects have been spawned by the task forces whose members give their time voluntarily and with dedication.
Some task forces have ceased, notably the Employment Task Force and Heart Health and Nutrition Task Force. The Employment Task Force organised a conference on unemployment at Bellambi, a seminar on Greenhouse and Industry with Business and Regional Development, and the Buy Illawarra - Create a Job Campaign. Although there was good support from some sections of the community (e.g., local television) for the Buy Illawarra Campaign, other sections displayed little interest and the Task Force faltered in its thrust. However, Kiama Council still use the slogan "Buy Illawarra - Create a Job" on their stationery.
The Heart Health/Nutrition Task Force was initially involved with the IAHS in a large cholesterol screening campaign, then worked with Wollongong University, IAHS and local government on a food take away accreditation scheme which has since been taken up by Shellharbour and Kiama Councils. The task force also worked to change food choices of four large workplace cafeterias and gave great assistance in the Cringila and Bellambi General Practitioner Demonstration Grants. The Task Force ceased because of a number of factors, including the inability to raise funds for further projects and the loss of the dynamic chairperson, Heather Yeatman, from the Wollongong University of School of Public Health and Nutrition. Some of the functions were taken over by the IAHS Health Promotion Unit who had recently employed a number of nutritionists. The rest of the functions such as food gardens, breakfast programs, general practice grants in nutrition, etc. continue to be carried out by Healthy Cities staff and the chairperson.
Aged Task Force
This task force is composed of representatives from 22 different organisations and community groups who deal with issues pertinent to the elderly. Its first chairperson was Mrs Sally Bowen who has fought for services for the community for many years and also represented the Miners Women's Auxiliary. It is currently chaired by Margaret Lough from Community Options.
Over the years the task force has adopted a strong lobbying and advocacy role for issues such as adequate numbers of nursing home and hostel beds, respite and day care, the particular needs of the ethnic aged, disabled access, podiatry services etc.
Early in its life the task force helped to initiate the Wollongong University of the Third Age; sponsored together with Wollongong Council and others, a Health Services and Community Aged Expo; has conducted a number of public events such as a Vietnamese poetry reading - the first time this poetry had been read in Wollongong with, as a result, ethnic poetry reading being incorporated into the Illawarra Folk Festival. It was at this initial poetry reading event that Sally Bowen first read her own poems which subsequently led to the publication by Wollongong Council of a book of her poems "A Garland of Poetry" which won the Australian Fellowship of Writers best new publication for the 1995 annual award.
Because of its wide representation, the task force often acts in a co-ordination and information sharing role. It spawns many new ideas. Examples of these include its concern for problems of medication usage, particularly by the ethnic elderly which led to a general practice grant being obtained in this area. Similar concern with the diagnosis and support of persons with dementia led to a further general practice grant application being made in this area.
The task force is currently concerned with issues such as safety, isolation and loneliness. Support has been given to recruit seniors to the Reading Support Program with the NSW Department of School Education. A working party has also been set up to improve the availability of a sitting service in the central Wollongong area.
Cholesterol screening van 1988
AIDS Task Force
The AIDS Task Force includes representation from local government, AIDS Council of NSW (ACON), IAHS HIV/AIDS Prevention Service, Sexual Health Unit, Needle Exchange, Adolescent Drug and Alcohol, Public Health Unit, Community Support Network, people living with HIV/AIDS, Department of School Education, Aboriginal Health, Anti-Discrimination Board, Migrant Health and University of Wollongong. It was originally chaired by Dr Peg MacLeod, Head of the Equal Opportunity Office at the University of Wollongong, later Tony Mills from Healthy Cities Illawarra and currently Dr Christine Hayward from the University of Wollongong. The task force employs a project officer, Robyn Langlands, with funding from the NSW Health Department.
In its early days the task force was faced with widespread public discrimination against people suffering from AIDS, mainly caused by fear and ignorance. It thus instigated widespread media coverage and held two very successful "AIDS in the Workplace" seminars with large numbers of workplaces participating. A particular target has been the media themselves. The University of Wollongong World AIDS Day and Open Day sees many activities by task force members each year including an entire week of activities and various cultural and other events which have included presentation of a play by the Creative Arts Department, the AIDS quilt display, distribution of condoms and promotional material at Australian Universities Games held in Wollongong etc.
In 1992 a survey entitled "Knowledge and Attitudes to AIDS in the Illawarra" was carried out by a Masters student from the University of Western Sydney. This found higher rates of discrimination among some sections of the community. Its recommendations still provide guidance for ongoing programs. A study was also carried out by the Wollongong University Faculty of Education titled "AIDS Education in a Tertiary Setting - Litmus Test for Efficiency".
Schools have also received much attention with such activities as poster, radio competitions, educational programs, kits for teachers and a competition for a play addressing AIDS issues. This was subsequently performed at a number of schools and to the general public at the Illawarra Performing Arts Centre.
A poster competition for the general public was also held and the winning entry has become the official AIDS Task Force poster. Similarly a song competition was also held.
Other groups in the community which have been targeted by the task force are travel agents with a purpose run seminar and follow up, hairdressers similarly with production of a pamphlet "Curly Questions", hotels and clubs, heavy industry and seamen at Port Kembla. An AIDS Red Dog money collection box has been designed and placed in banks. Community golf days have also been held with funds raised going to support people living with HIV/AIDS.
World AIDS Week is a focus of widespread activities. Processions, youth rock festivals, concerts, quilt unfolding and displays, sale of red ribbons, distribution of AIDS coasters to hotels and clubs are just some of these. A candlelight vigil is held annually in May.
The project officer has been involved with Berkeley High School in the collation of a Youth Services Directory for students with problems involving sexuality, drugs and alcohol, accommodation and employment and legal and health issues.
A community garden has also been established at "Our Pathways" - a drop in centre for people living with HIV/AIDS.
One of the task force's most important roles is that of co-ordination and support to its members with one member conducting a regular radio session on the ABC entitled "Positive Voice". It also undertakes a lobbying and advocacy role being involved in such issues as housing and transport for people living with HIV/AIDS.
The task force can be proud of the part it has played in bringing the issue of HIV/AIDS to the attention of the Illawarra community and the pro active stance in education and community awareness and the support of people living with HIV/AIDS.
AIDS Candlelight Vigil Photo courtesy "Illawarra Mercury"
Child Injury Prevention
The need for this task force came out of a concern by Shellharbour Hospital and Council, the local community and the IAHS Paediatrician, Dr David Jeffs, at the high level of childhood accidents in the Shellharbour municipality. Over the years the task force has been chaired by Dr David Jeffs, Council's Youth Worker Nick Higgins, community members Tessa Parsons and Sharon Bird, Shellharbour Councillor May Hudson and currently Jill Vickery from the Health Promotion Unit. Kiama Municipal Council is also represented on this task force as well as IAHS Health Promotion Unit, Child and Family and Migrant Health Services, Shellharbour Hospital, Police, pre-school and playgroup associations, Roads and Traffic Authority (RTA), Department of School Education, Public Health Unit and Safe Communities Program.
With the aid of Shellharbour Hospital, NSW Health Department, Public Health Unit and a NH&MRC grant, a project officer and a research officer were obtained to gather statistics from local hospital accident and emergency units and assist the task force. Thus the Illawarra became the first community in NSW to collect area wide statistics in this field. Short surveys of similar attendances to local general practitioners were also carried out.
On the basis of these studies, together with a community survey, it was found that backyard, home and bicycle injuries were the commonest amongst children. A number of strategies were carried out: backyard clean-ups instituted by Shellharbour Council with assistance from local service clubs; community education sessions at playgroups and pre-schools and displays at local shopping centres. Systematic lobbying for compulsory bicycle helmets for children was carried out together with co-operation with bicycle shop proprietors to heighten awareness and interest. The idea of a bicycle park to promote safety, to be used by all schools, was formed early in the life of the task force. This eventually came to fruition in 1993 through a Federal Government road safety grant and co-operation with the NSW Police Service, RTA, Department of School Education and Lake Illawarra Police Citizens Youth Club. However, because of funding and staffing difficulties it did not become fully operational until 1995.
Another initiative that originated within the task force was the Early Childhood Injury Prevention Project (ECIPP) which educated early childhood nurses to inform parents about childhood injuries and their prevention. Likewise, the Student Committees for Injury Prevention (SCIP) headed by Jill Vickery which was funded initially by the Public Health Unit in co-operation with the Department of School Education. This targeted six pilot schools in a student led identification of accident causes and subsequent prevention. It resulted in a 30% reduction of accidents in the pilot schools. The task force is still trying to get this program adopted statewide. Many child safety expos at various locations have been held.
Of recent years the task force has adopted an area-wide focus and was one of the initiators of the need for an overall Safe Communities Program. With the completion of the NH&MRC grant and the gaining of funding from the Roads and Traffic Authority (RTA) for the Safe Communities Program, these latter two initiatives became part of this latter program. The task force and Safe Communities have continued to work closely together on such issues as the promotion of properly fitted restraints in cars for children, child restraints in taxis, fire safety, scalds campaign, safe playground equipment, prevention of dog bites, water safety etc. As a result of all these activities, childhood hospital admissions to accident and emergency departments dropped by 17%.
A major effort with the Illawarra Safe Communities Program involving many sectors of the community is made each year for National Kidsafe Week in June. In 1997 some 700 home safety packs were distributed between Wollongong and Kiama. Stop a Bite brochures were re-printed for distribution by the three local government councils to registered dog owners and 100 bicycle safety packs were also distributed to young cyclists wearing properly fitted helmets.
Transport and Environment Task Force (formerly Pollution Task Force)
In 1987 air pollution was seen by the public as the major problem facing the Illawarra. The original task force had representation from BHP, Electrolytic Refinery and Smelter (ER&S), the then State Pollution Control
Commission (now Environment Protection Authority), Wollongong City Council, IAHS, Health Promotion Unit, University of Wollongong and the community. Of particular concern was the emission of lead from the ER&S copper smelter (later renamed Southern Copper) which is situated very close to the Port Kembla community including three schools. A $60,000 grant was obtained from NSW Department of Health and $2,200 from Wollongong Council to investigate this problem and the effect it was having on very young children in the vicinity through inhalation and raised soil lead levels. This Wollongong Lead Study did show raised blood levels in 10% of the 83 young children tested above the then recommended level of concern of 25 mg/dL. This level has since been set at 10 mg/dL. At the time of the study, public education was carried out to make families in the affected areas aware of simple precautions they could take to lessen the risk.
In 1991 the name of the Task Force changed to Transport and Environment. It is now chaired by Dr. Philip Laird who, as well as being employed by Wollongong University, is also on a number of community transport committees. Various representatives joined the task force including City Rail, Bus and Coach Association, Shellharbour Council, Wollongong City Council, Environment Protection Authority (EPA), Illawarra Public Health Unit, Roads and Traffic Authority, Department of Urban Affairs and Planning, Department of Transport, Port Kembla Coal Terminal, community representatives and IAHS.
With regard to the copper smelter at Port Kembla, the EPA imposed more stringent controls in 1992 which eventually led to ER&S ceasing production in 1994 with resultant drop in lead emissions. However there still remains concern about lead levels which has been the subject of a recent study by the Public Health Unit and University of Wollongong. A submission from the task force to the 1995 Commission of Enquiry was also made. The re-opening of the copper smelter under new management with improved technology will now occur but community concern remains high. The task force commissioned a report on the development application by the new management which was sent to the EPA and appropriate state bodies, media and politicians. It also organised a meeting between the residents and the new management and was represented at a deputation with various State Ministers and will continue to monitor progress.
In March, 1992 the EPA and Healthy Cities jointly funded a report for the Task Force by Drs. Ann Young and Philip Laird entitled "Illawarra Environment 1992 - Air Quality and Transport Options". The findings were that while air pollution had not dropped in the immediate vicinity of the Port Kembla industrial area it had reduced substantially throughout the Wollongong area. However the impact of increasing motor vehicle use for passengers and freight was having a major effect on air pollution and noise. A large number of recommendations were made which the Task Force is still working towards. A Traffic Noise Study was also carried out in 1992 by Healthy Cities Illawarra and the EPA. This study found increased noise levels along major road arterials and suggested more freight be carried by rail and the erection of noise barriers.
It is believed that the task force has assisted with greater co-ordination and liaison between the various bodies and with the representation to those bodies of community concern. Its aims are to help reduce reliance on fossil fuels, encourage the use of public transport and bicycles, help improve air quality and reduce noise. The task force has adopted a heavy lobbying role to seek improvements in public transport and in 1995 published an information brochure 'Sustainable Transport for the Illawarra' which was widely distributed to schools and organisations throughout the community. It has also lobbied consistently for the preparation of a Regional Transport Plan which is, at last being carried out. Particular emphasis has been given to a major bus-rail interchange at Oak Flats and electrification of the railway line to Kiama as well as reduction of road haulage of coal.
Recently the task force initiated discussions between Wollongong University, the Department of Transport, bus and rail operators, student representatives and others, to investigate and make recommendations and actions towards improving traffic flow and public transport services in and around the University which generates 30,000 people movements daily. This has resulted in the production of an innovative integrated bus- rail-cycle timetable issued to all students and staff which has also been placed on the Internet - a first in Australia. Also, the institution of a heavily patronised direct Wollongong City-University bus route and numerous improvements to timetabling and services have also occurred. A major bus/cycle interchange at the university has been designed and combined rail-bus ticketing is being investigated. When the State Minister for Transport launched the timetable he stated it was a model for NSW and the forthcoming Olympic Games.
Coke Ovens at Port Kembla
QUIT Action Committee
This committee has been chaired up until recently by Dr Jim Turner, a general practitioner with a lifelong interest in the prevention and cessation of smoking. It is currently chaired by Julie Davis from the Cancer Council. This committee is a joint venture with the IAHS Kembla House Drug and Alcohol Service which employs a QUIT anti smoking project officer who plays a large role in the committee. Other representation includes IAHS Adolescent and Community Health Services, Department of School Education, Cancer Council, local government, Public Health Unit, Life Education Centre and Illawarra Division of General Practice.
The committee has helped lead to many innovative community programs such as multiple activities throughout the whole community for the regular annual QUIT Week. Particular sections of the community which have been targeted are schools and university students, hotels, clubs and restaurants, hairdressers, new mothers, sporting groups etc. Regular direct lobbying has ensured that all major shopping centres are now smoke free. Concern regarding the rising incidence of smoking amongst young people, particularly females, has led to the obtaining of a general practice grant to employ a project officer to harness surrounding general practitioners and community to assist in the reduction of smoking at a local high school in a student led initiative. This project also targets patients of the GPs. The committee works closely with the Public Health Unit to prosecute tobacco outlets selling tobacco to minors. A recent initiative has been promoting non- smoking role models in the entertainment industry.
Assistance has been given to this committee by such bodies as health funds and the makers of smoking reduction measures such as Nicobate. Strong links have been made with the Cancer Council and Asthma Committee. Press and media releases keep the issues constantly before the public. Regular public events use appropriate television, sporting and other role models and input is given to many community festivals and happenings.
Health promotion activities, Wollongong City Mall Amphitheatre - October 1990
Spreading the Message across Australia and Overseas
Following its inception, Healthy Cities Illawarra has attempted to encourage the spread of the movement across Australia and overseas. Since the first three years which are detailed on pages 10-12, we have participated at the launch of Bankstown, Griffith and Liverpool Healthy Cities and more recently, Healthy Villages Blue Mountains. We have also given assistance to Healthy Cities Port Macquarie, Camden- Wollondilly, and the more recent Hawkesbury-Windsor Healthy City.
Since the National Office closed in 1992 we have worked closely with Healthy Cities and Shires Queensland, first with Carole Lowe then with Peter Davey and Paula Chapman to try and bridge the gap left by the National Office.
Healthy Cities projects in Australia as well as interested others, receive a copy of our quarterly report.
In 1993 Pat Mowbray and Iris McLeod, Regional Aboriginal Health Co-ordinator, undertook a four day visit, consisting of public meetings with senior health personnel, local government and three Aboriginal committees, at the invitation of the Eastern Metropolitan Health Service of Perth to look at Aboriginal Health Services and outline the Healthy Cities approach. We had already given considerable help to Healthy Cities Gasgoyne and to Healthway - an organisation interested in the development of Healthy Community initiatives in Western Australia.
Pat Mowbray visited Eastern Europe in 1993 as part of a Citizen Ambassador program and presented her paper on Healthy Cities. Likewise a WHO Healthy Cities Conference in Zagreb in 1992. Also in 1993, Tony Mills and Pat Mowbray represented Healthy Cities Illawarra in San Francisco at the 1st International Conference on Healthy Cities. Healthy Cities Illawarra had been asked to present a paper as one of the fifteen exemplary Healthy Cities in the world.
After receiving a three day visit by Professor Takehito Takano from Healthy Cities Tokyo in 1994, Pat Mowbray was invited to be a panelist at the International Forum on Health Promotion in Tokyo in September 1996. This conference was attended by 1,000 people from all over Japan. Only eight non-Japanese attended, including Dr Ilona Kickbusch and three others from the World Health Organisation.
We have also presented at the NSW State Healthy Cities Seminar and the 2nd National Conference on Healthy Cities, both in 1992. Papers on aspects of Healthy Cities have been presented at most Public Health Association Conferences since 1989 and some Community Health Association and National Health Promotion conferences. Presentations were also made in 1995 to Queensland Healthy Cities and Shires Conference in Cairns and the National Health Promotion Conference in 1996. A short paper on Healthy Cities was forwarded to the World Health Promotion Conference in Jakarta in 1997 as part of the proceedings of the National Health Promotion's Conference "Ottawa - Ten Years On".
In March 1993 we organised an all day seminar and visits, "Illawarra - A Healthy City in Action" whic h was attended by some 40 participants across NSW.
We have also received visits from Te Puke Bay of Plenty in New Zealand, Western Cape and Natal South Africa, Sunshine Coast Queensland, Campbelltown, Queensland Healthy Cities and Shires and recently Shanghai and Beijing.
In 1992, after receiving written and verbal submissions from Healthy Cities across Australia including the Illawarra, the report "Improving Australia's Health - the Role of Primary Health Care" by the National Centre for Epidemiology and Population Health, made five major recommendations to the Commonwealth Department of Health, Housing and Community Services, one of which was the "funding consolidation and expansion of Healthy Cities".
In 1994 we were instrumental in bringing out Ellis Katsof from Healthy Communities Ontario and with him visited Canberra and Blacktown Healthy Cities. We have also been a regular contributor to various WHO newsletters and publications.
NSW Healthy Cities Liaison Group
In 1996 we instituted the Healthy Cities NSW Liaison Group which all NSW Healthy Cities are invited to attend. This is an intersectoral committee designed to increase awareness of Healthy Cities, work more closely with local government and upgrade training in the concept for health and local government workers. This group has been co-sponsored by the Regional Health Development Centre of the WHO at the University of NSW. Through this group we have been able to offer assistance to five Pacific Islands. Representation on the group includes NSW Health Department, Public Health Association, Local Government Association, Australian Institute of Environmental Health, Centre for Local Government - Sydney University of Technology, Universities of Western Sydney (Hawkesbury Campus) and Wollongong and the Environment Protection Authority. For further information on working with local government, see section on Working with Local Government - Municipal Health Planning, pages 32/33.
Pat Mowbray is the Environmental Health representative for the Special Interest Group of the Public Health Association in NSW and Peter Davey, Chair of Queensland Healthy Cities and Shires, is the national chairman. One of his aims is to bring together health and local government workers in shared training and action to improve health, the economy and the environment.
In 1995 Pat Mowbray was also selected in a three year appointment to be one of the members of the NSW Premier's Council for Women and has used her experience in Healthy Cities in a whole of government approach to the needs of women, particularly in the areas of health, quality of life, the environment and violence against women.
We have submitted to numerous health and health promotion reviews, both Federal and State, including the most recent "Health Australia Review". We have a regular column in the Lake Times and Advertiser newspapers and issue numerous media releases.
Healthy Cities was also represented at a WHO Conference "Creating Healthy Places" organised by the Universities of Western Sydney and New South Wales.
Sunday 7 April, 1996 was designated by the WHO as Healthy Cities Day, and a native Cheese Tree was planted at Kiama on this occasion.
It is great to be part of this rapidly growing movement and in particular to see its growth in Asia where 150 healthy cities, towns, villages and islands have recently joined.
Working with Key Organisations
NSW Health Department, Illawarra Area Health Service and Illawarra Public Health Unit
We are very grateful for the support given us by the NSW Health Department, particularly health promotion who have always taken an interest in our development. Also to the Board, Management and staff of the IAHS and to the Illawarra Public Health Unit. Health Promotion, Community Health Services and the Public Health Unit are represented on our Management Committee and we, in turn are represented on the Public Health Unit's Steering Committee. There are many joint programs between us all as outlined previously where we assist one another directly. On other issues we adopt a complementary role and provide the community development and participation aspects.
We particularly liaise on national and state health priorities and look forward to a fruitful continuing relationship.
Illawarra Division of General Practice
Healthy Cities Illawarra has been actively involved with the Division since its inception and has representation on their advisory committee. Even before the Division was formed we were working closely with individual general practitioners, particularly since the institution of the Commonwealth General Practice Grants. Recognising the key role of GPs in health promotion and community development, we have assisted GPs to obtain and implement grants at Berkeley, Cringila, Sanctuary Point, Culburra, Warrawong and Warilla, Bellambi (now whole Northern Suburbs) and central Wollongong. By forming a small management committee for each project with a much wider advisory committee drawn from many sectors, the grants bring together GPs, community health and other relevant services and the local community.
The great majority of these grants have been in disadvantaged areas and have been able to build upon work already done by services and Healthy Cities. All GPs receive a copy of our quarterly report.
The Division offers excellent support and educational programs to GPs and it is our view that these together with the grant system have given great benefits to GPs and the community.
Working with Local Government
Local government input from the four local governments in the area we cover has been an essential part of our development. We have been able to tap into their resources for joint programs and value their expertise and knowledge of their community. They are represented on our management committee and help direct the project.
At a regional level, Healthy Cities is represented on the Illawarra Region Organisation of Councils (IROC) Regional Environmental Strategy Committee which also has support from the Illawarra Regional and Economic Development Boards. Healthy Cities is also involved with Shellharbour Council and Wollongong University in a review of current rural land use and is represented on the Ecological Sustainable Development Committee of Wollongong City Council.
Local government staff are on virtually all our task forces and are a part of the majority of community programs, particularly where they are of an environmental nature. We could not function without the support of councillors and local government staff.
Municipal Health Planning
Following the example of Queensland Healthy Cities and Shires and the discussions coming out of the NSW Healthy Cities Liaison Group, Healthy Cities Illawarra has recently undertaken a Municipal Health Planning exercise with Kiama Municipal Council, schools, Environment Protection Authority, Public Health Unit, IAHS and Consumer Watch Group. This will involve bringing the economy, the environment and the whole
community together to improve the health of the people of the Kiama municipality and their surroundings. Queensland Healthy Cities and Shires which has been funded by the Queensland Health Department is currently working with nine local government areas in this manner, an area two thirds the size of Queensland.
The process commences with getting the key players together and gathering relevant information, data and reports. Vision workshops are undertaken with the whole community - schools, council, business and industry, agriculture, cottage industries, health services, community groups etc. and facilitators are trained from the community to run these workshops. Then groups from geographic areas come together to share their vision and formulate strategies to help bring about this vision. Those appropriate to local government will be written into their Corporate Plan for implementation and it is anticipated other groups will do likewise.
In Kiama we have the wholehearted support of the Mayor Joyce Wheatley and the Deputy Mayor Sandra McCarthy and all the councillors as well as the General Manager and his staff. Shellharbour and Wollongong City Councils are also sending a representative with a view to undertaking this process in the future.
We think this is a first for NSW in its breadth and scope. We have been fortunate also to work with the Environmental Health Department in this respect at Wollongong University. A student doing her Masters will make this her major project.
Shoalhaven Healthy Cities and Shoalhaven City Council have also undertaken a Vision process throughout the Shoalhaven community (see pages 40/41).
University of Wollongong
The University was one of the initiators of our project and has always been represented on the Management Committee. We have had particularly close relations with the Faculty of Health and Behavioural Sciences. From 1989-1993 the Community Health Services Diploma and Masters Degrees had a large component of the concept and practice of Healthy Cities and Healthy Cities communication seminars were run in summer sessions. In 1992 Healthy Cities was involved in the successful application for the National Reference Centre for Primary Health Care and was subsequently represented on the management committee. We have also had input into the nursing course.
In 1996 Healthy Cities is one of the guest lecturers in the newly created Masters in Environmental Health course run by Dr Irene Kreis and had input into its curriculum and intersectoral nature. A student from this course is doing her major project on Kiama Municipal Health Planning. Healthy Cities and the University are also working together to establish an indigenous art collection and improve bicycle access.
Futureworld - the National Centre for Appropriate Technology
In keeping with its objective to contribute to ecologically sustainable development, Healthy Cities Illawarra has assisted Futureworld from its beginnings in 1991 and is represented on the management committee. A non-profit community based organisation, Futureworld is the brainchild of Dr Judy Messer from the Nature Conservation Council of NSW. It represents a holistic approach to the demonstration and encouragement of appropriate technology. It is being developed at Cringila above the Cringila Community Park on land leased by Wollongong City Council. When it is fully developed it will consist of a large demonstration centre, a number of houses and their contents and a field studies centre for schools. All buildings will be built with the principles of ecological sustainable development and the site itself will provide necessary energy and water. There will also be outdoor displays of solar power, water harvesting, wind power, permaculture and land rehabilitation. Business and industry will be able to demonstrate their appropriate technology and a small conference centre, bookshop, database, library and cafe will cater for education and information needs. The centre is aimed at the general public, tourists, schools, business and industry and appropriate community groups.
Key players have been local government, Sydney Water, Healthy Cities Illawarra, Environment Protection Authority and University of Wollongong where there is a formal agreement with the Environmental Research Unit.
Following two public meetings with the Cringila community to familiarise them with the project, an Environmental Fair comprising some 60 exhibitors was held on the site in 1992. In 1994 Futureworld organised an international conference at Wollongong University "Protecting the Future - ESD in Action" which was attended by 180 participants. Healthy Cities assisted this conference and was also instrumental in bringing out Ellis Katsof from Healthy Communities Ontario, Canada. The conference which had wide international and national representation recognised in its proceedings the absolute necessity of bringing the environment, the economy and health together with the community. Thus economists, local government and health workers, industry, business, architects and builders, BHP, environmentalists, scientists, farmers and community came together to deliver this message and to give many practical examples. Following the conference, Ellis Katsof presented workshops on Healthy and Sustainable Communities in Wollongong, Canberra and Blacktown.
In 1995 a full time co-ordinator, Catrina Bleicher, was appointed with Commonwealth funding through the Department of Employment, Education and Training (DEET). Two grants totalling $30,000 were received from the National Landcare Program to commence site development, landscaping and water harvesting. Twelve LEAP Scheme trainees auspiced by the YWCA contributed. In 1995 two Environmental Trust grants were successfully gained; one for $31,200 for rehabilitation of the western slope and the other for $22,650 to produce an environmental technology kit for primary schools.
Meetings were also held with Kembla Green Corridor and Wollongong City Council re a walking track between the new Buddhist Nan Tien Temple and Futureworld.
In late 1995 a Business and Regional Development grant of $20,000 was given to commence architectural drawings for a security building and residence and the main exhibition hall. An Eco-House has also been designed. A grant was also received in conjunction with Wollongong City Council for erection of a solar power, wind and water pump on site, suitable for rural properties not connected to electricity or water.
In 1996 all these projects are proceeding together with dam and wetland construction. A major clean-up of the site with assistance from Wollongong City Council, four wheel drive clubs, residents from Cringila and Rover Scouts took place on Clean Up Australia Day.
Recently Futureworld received two large grants from the NSW State Government to set up a comprehensive cleaner production project in small and medium key industries in the Illawarra in conjunction with the Illawarra Waste Management Board. Numerous tree planting days have also been held. It is envisaged that
Futureworld will link closely with Industry World and provide a tourist attraction as well as offering demonstrations and education to all parts of the community.
Greenbags
Healthy Cities Illawarra and Jewel Food Stores joined forces on World Environment Day 1997 to sell calico Greenbags as an alternative to plastic bags at all Jewel supermarkets throughout June 1997. Jewel was delighted with the success of the Greenbag promotion and is considering including Greenbags as a standard stock item.
Global Ecohealth Network (www.vianet.net.au/ eco-heal)
This network of which Healthy Cities is a core member is now established and growing rapidly across the world with many Healthy Cities joining as well as numerous individuals and organisations who are concerned about and want to tackle the threat to public health caused by the deteriorating world environment. It is envisaged that it will link with koori.net.au - a worldwide indigenous network which is now being established in the Illawarra. The NSW launch of the Global Ecohealth Network will take place in October 1997.
Working with Other Sectors
We believe successful working with other sectors depends on a philosophy of mind - a willingness to look at the cause, effect and solution of any problem in its entirety. Taking this approach automatically includes other organisations, groups and individuals who can work together to provide more effective solutions, some as a group and some in their own organisation. For participants to contribute fully their opinion must be valued and opportunities made for them to express their ideas. Quite often a solution comes from an unexpected source.
Healthy Cities Shoalhaven compiled by Penny Lumb, Project Officer
Background
Shoalhaven is a paradox. It has the status of a city and is made up of 49 distinct and isolated towns and villages. There are two main commercial/residential areas: Nowra-Bomaderry in the north and Milton- Ulladulla in the south. The geographic area is much larger than any other local government area in the Illawarra and stretches for 100 km at the southern end of the region’s coastal strip. About 70% of this area is either State Forest or National Parks.
The Shoalhaven has the second highest population in the region (about 74,000, or 20% of the total), exceeded only by Wollongong, and experiences one of the highest growth rates in the State of around 4%. Most of this population live on the coastal fringe. We have a significantly higher than average proportion of senior residents and a high unemployment rate (16.5% in 1991). Services do not keep pace with the rapid growth and are difficult to deliver to the large and scattered population. It’s renowned natural beauty consistently rates it as the number one holiday destination in the State, which increases the population by three to four times during peak seasons.
Getting started in Shoalhaven
The Shoalhaven project emerged from the success of Healthy Cities Illawarra. Peter Collins, Minister for Health at the time, attended the first Healthy Cities Australia National Conference held in Wollongong, February 1990. He was so impressed with the course of the pilot program, he promised an extra $100,000 for the Illawarra project to expand. A community nurse from Nowra, heard this statement and immediately saw an opportunity for Shoalhaven to be included. She discussed the idea with Dr Pat Mowbray, and the process was set in place for Healthy Cities Shoalhaven to be established using a proportion of these funds.
Action was taken very quickly. In March, Brian Stewart, the Illawarra project manager sent letters to a number of Shoalhaven residents representing Local and State Government, Health, and the community, inviting them to discuss the formation of a steering committee and the "possible" establishment of the project in Shoalhaven. Following an enthusiastic response, a larger meeting with broader representation was held in July, from which a steering committee emerged. The process was gathering momentum and in September, with the background work done, a third meeting was held to form a management committee and canvass views regarding needs in Shoalhaven.
The first meeting of the Healthy Cities Shoalhaven Management Committee was held on September 20, 1990. Representation from Shoalhaven City Council (1), HMAS Albatross (1), Illawarra Area Health Service (3) including the Aboriginal Health Unit, community (3), with provision for one representative to come from each of the task forces as they became established.
Arrangements began for the appointment of a part time project co ordinator, for which $20,000 had been set aside, and Council’s Community Development Officer took on the role of organising public forums for Nowra, Ulladulla and St Georges Basin.
The invitation to these forums stated that “....experience from both the Illawarra and throughout the world shows that local communities can become far better places to live if all sectors of that community pitch in and do what they can to improve their environment and promote healthier life style practices.”
It made the request to:
• think about issues which affect health everyday
• consider ways in which these issues can be addressed in a practical way, even if only to a limited extent
• come along to one of the public forums to hear more about Healthy Cities and discuss suggestions for addressing local issues.
These meetings were held in November, and from them emerged three main task forces.
1. Cycleways 2. Environment 3. AIDS
The co-ordinator commenced employment (20hrs/week) in May 1991. Healthy Cities Illawarra negotiated with Community Health regarding clerical support and office accommodation. When the co ordinator began it was agreed that she would base herself in two of the community health centres – Nowra for two days and Ulladulla, one day. This worked for a time although it was never quite satisfactory. Eventually the co ordinator established herself in Ulladulla, where office space was secured for three days a week. This also provided consistent access to clerical support.
With these things in place work began on specific projects.
AIDS: Because of the geography of Shoalhaven, two task forces were established–one in Nowra and one in Ulladulla. Eventually the Ulladulla group was taken over by the Area Health AIDS co ordinator (late 1994) and the Nowra group become self sufficient. Activities included;
• bringing World AIDS Day to Shoalhaven with press releases, stalls, red ribbons, condoms and information each year
• education for members of the taskforce with speakers, videos etc.
• community education through media, doctors surgeries, youth week, one day workshop (Nowra) and information evening (Ulladulla), stall at Blessing of the Fleet
• encouraging local clubs and hotels to install condom vending machines. This extended to providing two machines, one to the Mollymook Surf Club and one to the local cinema in Ulladulla
• a three part education package for Ulladulla High School P & C plus other talks to community organisations including Rotary and Lions
• bringing the Safe Summer Safari Van to Shoalhaven
• bringing sections of the AIDS quilt to Nowra and Ulladulla
• funding a CSN training course run by ACON and held at Sanctuary Point
• negotiating with Council for signs to be installed in public toilets
• performances in Shoalhaven by unemployed youth of "Poor Naked Wretches", a play written by Dapto High School students. This group established themselves as Mad Talent and went on to other productions including one they wrote themselves with assistance from a community writer, on domestic violence.
• Community Educators training program run by the IAHS
• transportable murals painted by students from three high schools.
ENVIRONMENT: two specific needs emerged from the community consultations:
1. Shoalhaven River Seminar - the need here was for all parties to get together and share information about the history, current use and future of the River and introduce the concept and possibility of Total Catchment Management (TCM). This was held in Nowra, October 1991. A steering committee emerged from the Seminar and by September 1993 the Lower Shoalhaven Catchment Management Committee was in place with a paid co-ordinator. Healthy Cities continues to have strong links with TCM.
2. Mollymook Beach re vegetation – Working with the Dune Care Co- ordinator, Dept of Land and Water Conservation, district engineer, Shoalhaven City Council, Ulladulla Public School and the Ulladulla and Districts Garden Club, the Mollymook Dune Care group was established. A small grant was also secured from Greening Australia, representing the first funds to flow into Shoalhaven as the result of a Healthy Cities initiative. This remains an active group supported by the Landcare Specialist as part of Shoalhaven’s extensive Landcare network.
CYCLEWAYS: This taskforce was established and operational well before the Healthy Cities co-ordinator began work. The convener, who had attended one of the public meetings, was able to take on some of the cycleways activities as part of his paid work with the Dept of Defence, as one large section of cycleway was needed for naval employees to ride safely to work at HMAS Albatross. Being a social worker and committed to community development, he quickly established a network of groups representing major population centres all over Shoalhaven. He also made the necessary connections with Council engineers and town planners, which created the framework for a Cycleways Strategy to be developed. Over a twelve month period, groups met in the various villages to consider the best routes for cycleways. This information was taken to the Taskforce meetings for further discussion and then passed on to Council. By May 1992 the draft strategy was on public display. It was adopted by Council in June 1992 and now, four years later, it’s still slowly being implemented.
Three very successful bicycle rallies were held in Shoalhaven during the life of the Taskforce.
• in Ulladulla during Bicycle Week, 1992
• in Vincentia for the opening of the Vincentia/Sanctuary Point cycleway, late 1993
• in Nowra in support of the Albatross Road cycleway
The activities of this taskforce proved to be a very effective example of community working with local government. Healthy Cities received a letter of thanks from the General Manager acknowledging the role of the taskforce and stated, "community consultation is a worthwhile and valuable part of the planning process, and it helps to provide strategies and plans which are workable and responsive to the needs of the public."
More recently, a Community Vision has been published. Transport emerged as the highest priority with cycleways receiving special attention. On the basis of this, the Healthy Cities co ordinator convened a meeting with senior Council staff, councillors and the Cycleways Taskforce convenor. It was agreed that a Bicycle Users Group be established as a committee of Council. This is currently being negotiated.
The management committee and co ordinator were very active during these early days of 1991. Other activities included:
• bringing the Health Promotion van from Wollongong to operate in Shoalhaven
• meeting with Aboriginal Health workers
• designing and printing letterhead and business cards . The Shoalhaven Paper Mill agreed to a request for a donation of quality recycled paper - an arrangement which has been repeated twice since then
• approaching Nowra Skillshare to request an outreach office for Ulladulla
• Council asked Healthy Cities to organise the Clean Up Australia campaign for 1992. The co ordinator was unable to accept, so a member of the Healthy Cities management committee took it on with a $2000 donation from Council
• working with a disabilities organisation in Ulladulla to protect their place in the recycling industry, with the planned introduction of kerbside collections
• investigating opportunities for a hydrotherapy pool
• an evaluation and planning meeting was held in December. The following issues were identified for action in 1992. AIDS and Cycleways taskforces to continue. Recycling, accident prevention, Nowra East community, tree planting and a vision workshop to be activated.
These diverse activities saw the beginning of Healthy Cities Shoalhaven.
Major Activities 1992 – 1996
1. Recycling Taskforce
This was established as a result of working with the Ulladulla based disabilities organisation. The Council officer responsible for recycling joined the taskforce and other issues were tackled including;
• the establishment of Ulladulla tip as a recycling and buy back centre staffed by the disabilities group, and promoting this service in the community
• campaign to reduce the use of plastic bags in Milton and Ulladulla by giving away 1500 reusable shopping bags outside major supermarkets. Calico bags were screen printed and made in Milton and relevant stickers and brochures enclosed. The Taskforce also prepared a flyer with local information about plastic bags, waste minimisation and recycling options.
• encouraging Council to install the first recycling bank in Shoalhaven as a trial, which proved very successful.
• preparing press releases focusing on waste minimisation practices
• lobbying Council regarding options for the implementation of kerbside recycling
• commenting on Council’s Waste Management Strategy
• lobbying Council regarding the position of Recycling officer and suggesting that it become a full time position.
This eventually happened as did kerbside recycling and the activities of the taskforce came to an end.
2. Community Food Gardens at Jerrinja Aboriginal Community
See page 20 for details.
3. Breakfast Program at East Nowra Public School
This was already established and in need of some assistance. The Healthy Cities co ordinator and the community health nutritionist (also the secretary of the management committee) met with school representatives, and Healthy Cities took on the role of finding more volunteer workers and securing donations of food supplies from various companies. The result was that seven employees from a local building company were added to the volunteer roster and Australian Consolidated Foods, Sanitarium and Buttercup/Fielders with providing supplies.
4. Urban Environment Seminar
As a result of the Shoalhaven River Seminar, the local branch of the Australian Conservation Foundation approached Healthy Cities with a request to run a similar event based on the wider concept of the urban environment.
A broad based community and agency organising committee was formed and a significant process was begun. Shoalhaven 1993 and Beyond was held in March as a weekend conference at the Coolangatta Historic Village Resort. Even though it was fraught with difficulties before, during and after the event, it created a chain of events which over three years, achieved something of significance for Shoalhaven.
The vision workshop, which had been discussed by the Healthy Cities management committee, was offered at the conference as a workshop choice. One of the City’s elected representatives attended, and at the June Council meeting she moved that “the General Manager investigate the conduct of a vision workshop for senior Council staff and Aldermen to assist in compiling a Vision Document for the Shoalhaven.”
In February 1995 this workshop eventuated just as Healthy Cities decided to implement a community consultation process regarding a Vision for Shoalhaven, because it appeared that Council were not going to act. Healthy Cities approached Council and suggested a partnership and after submitting reports and speaking to the Policy and Planning Committee, Council agreed to the formation of the Vision Liaison Team.
This consisted of three Healthy Cities representatives (the co ordinator, the consultant who had been contracted to conduct the community consultation and the convener of the Cycleways Taskforce who had also helped organise and conduct the conference), and three Council representatives (the Mayor, the Deputy Mayor and the General Manager). This partnership represented the birth of Vision Shoalhaven with the first meeting held in August 1995.
The community was asked to submit vision statements answering the question, "How do you want Shoalhaven to be in twenty years time?" and a $500 prize was offered for the most inspiring vision. The message was put out through the media and Council printed and distributed a flyer with a rates mailing in October. Healthy Cities had established an Editorial Committee and in November that group chose the winning vision statement and awarded the $500 prize. The next task for the consultant was to summarise all the vision statements that had been received from the community and reduce them to brief statements in priority order. These emerged as transport, health, community/lifestyle, natural environment, built environment, economy. This information together with a draft vision statement, was sent out to the community for comment, in July 1996.
The vision statement used in the brochure, had been put together at Council’s February ‘95 workshop. Using the community’s contributions as a guiding principle, the liaison team significantly amended and simplified this statement. With this act the partnership confirmed itself and a significant event occurred. Council and community had together written a draft vision for the City of Shoalhaven.
Currently a City Plan is being developed. It is likely that all those who attended the 1993 conference and those who contributed vision statements will be invited to a workshop with Council staff and Councillors to finalise the wording of the vision statement. Following this it can be formally and officially adopted as the City’s strategic guide into the future.
5. Safety
Using the Illawarra model, a Safety Summit was held in Nowra on 29 October, 1992. Following this a Safety Liaison Committee was formed to “co ordinate and promote safety activities in Shoalhaven”. One specific objective was to "prevent death and injury by responding to specific areas of need and to support existing organisations".
Rock fishing had emerged at the Summit as an area of urgent need. Representatives from the Shoalhaven Rock Fishing Safety Awareness Committee had participated and were now members of the Liaison group. To support them in their work of having life buoys placed at the main rock fishing sites, the liaison team designed a flyer advertising the Marine Rescue radio frequency for emergency use. At the last minute the group was informed that this would interfere with SES emergency procedures, so the project was dropped.
This proved to be frustrating and disappointing, but the process continued on with the group deciding to change direction and work on safety issues for older people. This meant a change in the representation on the committee, which occurred naturally. An education program and brochure was developed with topics being: falls prevention, road use, feeling safe and secure, healthy lifestyles, nutrition, skills and interests. Following this, the group submitted a funding application to the Healthy Country Communities Competition and received funds to develop a Healthy Arts program for older people.
It had taken two years to reach this point of clarity and direction, and it was well worth it. A community writer and artist were employed to work with groups all over Shoalhaven, to encourage older people to present issues around safety and well being. Graphically, two large banners were produced made up of many colourful squares each showing some way in which the artist values their wellbeing and safety. With the writer’s assistance, three performances were scripted and rehearsed. All of this was presented on February 23, 1996 in conjunction with the I Remember When awards. The banners are being displayed at venues around Shoalhaven and two of the plays are having repeat performances. One group, now calling themselves "The Unprofessionals" performed twice during Be Wise With Medicines week in July, 1996.
6. Storm Water Pollution
In September 1994 Healthy Cities submitted a successful application to the Environment Protection Authority Rivers Reborn Program, to conduct a community education program about storm water pollution which included stencilling drains and gutters with educational messages. In March 1995, the perfect project worker was employed–teacher, environmental scientist and artist– in what turned out to be one the most successful and well received projects undertaken by Healthy Cities - mainly because it was so visible. The project team consisted of the TCM co-ordinator, two Council engineers, a council environment officer, the project worker and the Healthy Cities Co-ordinator.
Community education included weekly press releases, radio interviews, school visits and presentations to interested clubs and organisations. This was followed by the drain stencilling which created wonderful community comment and support. The messages stated the drain’s destination; e.g., "Drains to Ulladulla Harbour", and the instruction, "Clean Water Only". Accompanying these messages were images of around 50 different marine creatures. Inquiries were received from all around the State from other local governments and community organisations. The general impression was that even though drain stencilling had been done before, the Shoalhaven example was more graphically effective and had greater impact.
The NSW Coastal Conference was held in Ulladulla in November 1996 and Council agreed to "freshen up" selected stencils for this event. Because of the interest generated by the project, the co–ordinator and the project worker delivered a joint paper at the Conference on storm water pollution and outlining the processes and practicalities of drain stencilling. Negotiations are now underway to extend the drain stencilling program to the year 2000.
7. The Clyde River
At the beginning of 1994, the co ordinator invited a group of people to develop a funding application to submit to the Commonwealth Department of Tourism’s, Forest Ecotourism Program. The focus of the project is an area of State Forest which includes four sites on the Upper Clyde River and Yadboro Creek. A resident of Yadboro had become increasingly concerned about the litter being left and environmental damage being caused by increasing numbers of visitors to these sensitive areas.
The team consisting of the concerned resident, State Forests, National Parks, tourist operators and users of the area, spent 5 months compiling what was to be a successful application. Along the way two other applications were also successfully lodged by the team. One was with the Forestry Mini Grants which enabled signs to be produced referring to litter and off road use of vehicles.
The other more sizeable grant from the Department of Water Resources, was for a management plan covering the non tidal section of the Clyde River. Two local consultants were engaged for this purpose and the draft plan is now complete and available for public comment. It was launched in August 1997 on the banks of the Bhundoo at Yadboro.
The Forest Ecotourism project, which completed its twelve months in June 1996, had five strands: patrolling on busy weekends and holidays which included distributing a visitor survey, installation of sign stands with interpretive information, vehicle barriers, an ecotourism workshop held on site at Yadboro and a brochure. In terms of the community development concepts of "one thing leads to another" and "from little things big things grow", this project has been very successful. For example, an excellent working relationship has developed with State Forests. Their in kind assistance and resource input has continually risen over the twelve months. They provided a vehicle and uniform for the two rangers who job shared the patrolling, they provided extra funds to install two pit toilets and the contract has now been extended for a further six months so that the scope of the brochure can expand, with State Forest’s funds, to include all of the Batemans Bay Forest District.
They also responded to information about a traineeship which has enabled one Koori ranger to continue with weekend patrolling for a further twelve months over a much wider area. This position of 'Ecotourism Ranger', is a first for State Forests.
The Ecotourism workshop also developed into something much bigger. An organisation now called Ecotourism Shoalhaven has been established and is liaising with a community based cultural tourism group and the Shoalhaven Tourism Board aiming “to develop ecologically sustainable tourism for Shoalhaven”.
A brochure is also being prepared on ecotourism in the entire Bateman's Bay Forest District. Healthy Cities Shoalhaven was also involved with National Water Week in 1996 and will make a presentation to the NSW Coastal Conference.
8. Coastcare
Funding was approved in January 1997 for the Lake Conjola/Narrawallee Bitou Bush Control Program and a management plan is being produced involving Council, National Parks and Wildlife Service and community volunteers. The project includes aerial spraying, community workshops and community education. An application for Stage 2 funding is currently being developed by Healthy Cities and the contractor.
9. Healthy Cities Awards
Originally the Shoalhaven awards were included with the Illawarra and presented in Wollongong. From 1992, the Shoalhaven co-ordinator organised a separate event which continues to be held annually in Nowra. This provides a positive vehicle for promoting Healthy Cities Shoalhaven to a captive audience as well as fulfilling the original purpose of acknowledging the work of individuals and groups in caring for their community. It remains a highlight of the year to be witness to the enthusiasm and optimism that people so willingly spread throughout the Shoalhaven.
10. Healthy Country Communities Competition
A two-part application is being prepared: one part in conjunction with Council, the second with Jirrawich Aboriginal Cultural Training (JACT) Association Inc. The aim will be to upgrade walking trails and other outdoor sites to disabled access standards.
11. Community Prayer Wheel
This was launched in May 1997 and was the culmination of eighteen months work. The launch took place at Milton Public School with the rainforest as a backdrop and is sure to become a much visited site on the south coast.
Visitors admire the Community Prayer Wheel at Milton Photo courtesy State Forests of NSW “The Bush Telegraph”
Supporting Communities since 1990
(a) Task Forces
For task force outcomes see appropriate section - pages 22-29.
(b) Physical and Social Changes
All these physical and social changes could not have been made without the assistance of others; e.g., local government, government and non-government departments, health services, business and industry, community groups etc.
Helensburgh
Commencing in the north at Helensburgh, one could point to the shadecloth over the children's swimming pool, the now completed youth centre and the footpath between the town and the railway station (2 kms) all of which the Healthy Cities Committee at Helensburgh successfully lobbied for, and in the case of the shadecloth, contributed to. Healthy Cities also joined the lobby to protect the Port Hacking River and adjoining bushland from overdevelopment and made representations regarding child safety of proposed retention ponds.
An asthma study of children at Helensburgh was organised and with the Asthma Committee ultimately led to the launch of the asthma kit for schools.
There has been lobbying to Wollongong City Council for measures to correct heavy water run off in particularly dangerous drains adjoining the public school.
Stanwell Park
Involved with Friends of Stanwell Park to improve the water quality of the lagoon that empties into the sea. Also lobbied for the installation of sewerage.
Thirroul Village
Here we have supported the Thirroul Arts and Seaside Festival which is now an annual event. This has led to greater encouragement and development of local arts and includes a tour of local artists in their homes and a children's art exhibition. Also supported "Growing Green Kids" Festival which takes place every two years. This has encouraged children's participation in and awareness of green issues.
Healthy Cities Illawarra supported action protesting the location of mobile phone towers near local primary schools.
Tarrawanna
Involved in the establishment of a No-Dig vegetable garden at Tarrawanna Public School which also involves senior citizens living nearby.
Bellambi (see pages 16/17 for further detail)
As Bellambi is the most disadvantaged suburb in the Wollongong local government area, Healthy Cities has had a major input into this area since its inception, chairing both the Bellambi Agencies Committee and the Bellambi Estate Advisory Board and is part of the Bellambi Creek Catchment Management Committee. Working largely with the Bellambi Neighbourhood Centre, Wollongong City Council and the community and as part of the above committees, one could point to the establishment of two playgrounds with picnic shelters and barbecues with a third on the way. (There were none when Healthy Cities held the original Vision workshop in 1987.) Improvements have also been made to street lighting, bus shelters, foreshore tree planting and landscaping, fencing, roundabouts, and a swimming pool that is now regularly emptied and cleaned out. Also the establishment and support of an ongoing community food garden adjacent to the Neighbourhood Centre and an ongoing breakfast program and in some cases lunch for school children. This has increased children's and families' good nutrition and children's learning ability. In turn there has been a new confidence in Bellambi people as the beauty of the area increases.
Healthy Cities also assisted with the gaining and implementation of a general practitioner grant to employ a nutritionist to work with the Bellambi people, shops and schools to promote healthy eating generally and establish exercise groups. This GP grant has currently been extended to the entire northern suburbs (Helensburgh to Fairy Meadow). Evaluation of the first twelve months of this grant showed improvements in nutrition practice at school canteen and shops, nutrition and dental practice at school and pre-school, improvements in nutrition and lifestyle in patients of general practitioners, community etc. (See Evaluation Report "Bellambi Health and Nutrition Project" - May 1995, Lisa Franco, Dr O Gupta.)
Fairy Meadow
Healthy Cities was approached by a community group headed by Sally Bowen, Aged Task Force Chairperson, to lobby Wollongong City Council and assist the community to establish Pop Errington Park. This park is now established, supported by regular community tree planting and is the site of an annual community Christmas Party.
Also initiated the first reading of Vietnamese poetry in public. This took place at Fairy Meadow where there is a large Vietnamese population. Now ethnic poetry reading is a regular part of the Illawarra Folk Festival.
Wollongong City
Established food garden with Wollongong City Mission youth refuge and ethnic communities. Supported the Folklorika Festival organising committee.
Healthy Cities has actively participated on the Management Committee of the Illawarra Migrant Resource Centre which published five books of poetry by ethnic poets.
Supported and participated in the Illawarra Academy of Sport Corporate Triathlon as well as supporting several community bicycle rides for school children and their families.
Gave support to Lifeline in gaining their Community Suicide Prevention Program (now implemented) and counselling and support to Torture and Trauma Victims and refugees. Also supported and took part in Lifeline's Women's Health Expo.
The Chairperson of Healthy Cities is also a member of the ESD Committee of Wollongong City Council. Recommendations of this committee become incorporated into the Wollongong City Council Corporate Plan for implementation. As a result an energy audit which will soon be part of the process for all new housing and additions and many recommendations re waste management, improvement to water quality of creeks, landcare etc. will be carried out.
Cringila (see page 18 for further details)
Here Healthy Cities has been involved since its inception with assistance to the Cringila Community Park. It is represented on the Cringila Park Management Committee and was instrumental in gaining the largest urban grant ever given by Greening Australia. The establishment of the park is ongoing but is already used widely by the community and is becoming a tourist attraction having as it does, trees from many nations.
Findings of a recent study have shown that the park "has provided a venue for physical activity, been a source of aesthetic and environmental benefit, enhanced community congeniality and provided a sense of civic pride for local residents". (Betty Gill and Edda Simeoni, "Residents Perceptions of an Environmental Enhancement Project in Australia", Health Promotion International, Volume 10, No. 1, pp 253-259, 1995)
General Practitioner Grant - Cringila Nutrition and Dental Project
In the above Final Project Report 1992-94, Debra Langridge and Cathryn Russell - Dr M Iqbal, it was quoted at the end of the project there were very positive changes both in numbers of children having breakfast and the type of food they ate; teachers observed an increase in attention span and participation before recess; a new and improved canteen policy was implemented and sandwich sales quadrupled. Teachers also reported positive changes in the lunches children brought to school; parents reported positive changes in the type of food taken to school and at home and to dental practice at home. Community awareness of the project and health services available was high, shops had ongoing healthy food displays and general practitioners conducted healthy lifestyle groups, had displays in surgeries and referred individual patients to necessary education. Nutrition and dental practice were incorporated into the school curriculum.
Finally the project led to the Department of School Education launching Healthy Schools (later entitled Health Promoting Schools Illawarra).
Futureworld - National Centre for Appropriate Technology (see pages 34/35 for further details)
Outcomes from the development of this proje ct so far have been greater overall community awareness of green issues following the Environmental Fair, the International Conference "Protecting the Future - ESD in Action" and the issuing of a regular newsletter. At Cringila the community and the Cringila Business and Industry Association have both greatly supported the project. The implementation of the various grants received have led to employment including youth employment. Futureworld is actively represented on the ESD Committee of Wollongong City Council and thus had input into the Corporate Plan and has also had input into Illawarra Regional Organisation of Councils (IROC) Environmental Plan. An Appropriate Technology kit for primary schools is being prepared and various eco-buildings to demonstrate appropriate technology are being designed.
Berkeley (see page 16 for further details)
Major results from involvement with this community have helped lead to transformation of the former degraded and vandalised shopping centre, numerous landscaping, tree planting and environmental improvements, establishment of a breakfast program at Berkeley High School, establishment of an ongoing food garden used for training youth and others and an ongoing nutrition program at the Neighbourhood Centre. Also with Berkeley High School, production of a directory for all youth. A general practitioner grant in 1992 raised community awareness and knowledge of good nutrition and gave participating general practitioners a simply nutrition tool for their patients. Overall the Berkeley Development Association has become a strong and effective organisation that represents its community with pride.
Warrawong
Healthy Cities has helped initiate and support the breakfast program at the Greene Street Community Centre. In conjunction with the IAHS Youth Drug and Alcohol Service and YMCA, Healthy Cities sponsored six teams of youths involved in a neighbourhood soccer competition.
Warrawong and Warilla
Healthy Cities assisted with the initiation and implementation of the GP grant "Management of Medication in the Ethnic Elderly", now in its second year of funding. The project involved seven general practitioners at Warrawong and Warilla, IAHS personnel, Migrant Health, pharmacists, Healthy Cities and community groups. It was reported that GPs enhanced their knowledge of effective prescription of appropriate medication to the target group through using Micromedix and appropriate education, increased liaison occurred between GPs, pharmacists, hospitals, community health workers and aged care assessment teams. General practitioners also linked with health education medication programs at day care centres and with community groups; e.g., Combined Pensioners Association, increased the usage of the Mediwise Card and developed systems and methods which could be spread throughout the Division of General Practice. General practitioners' patients at risk were also given assistance to more effectively use their medication.
Second year funding has seen the project spread to further general practitioners in areas of high ethnic population.
Port Kembla
Healthy Cities was involved with two lead studies of young children in the areas surrounding the industrial plant at Port Kembla. It has also been involved with the Hill 60 Landcare Group in environmental rehabilitation and tree planting.
Kemblawarra
Assistance was given to the Coomaditchie Aboriginal community which culminated in the community gaining funding for an environmental grant from the Commonwealth. As a result, native tree planting, an Aboriginal track, bush tucker plants and rehabilitation of the Coomaditchie Lagoon took place. This area has become an educational resource for schools.
Lake Illawarra (see pages 14/15 for further details on Project Armada)
Results of this massive clean-up included removal of 1,500 tonnes of rubbish from the lake and feeding creeks, an increased awareness by the community of the causes and effects of pollution of the lake, the ongoing appointment by Wollongong and Shellharbour Councils of honorary rangers for the lake and the encouragement to the Lake Management Committee and Lake Authority to combine into a more effective Lake Catchment Management Committee. This latter committee has implemented many improvements in water quality and appearance. In addition, as a result of the lake clean-up, Healthy Cities was asked to assist the Berkeley Development Association to improve the suburb of Berkeley.
Road Safety Park
A road safety park has now been established and is functioning on la nd adjoining the Lake Illawarra Police Citizens Youth Club. This park promotes all aspects of bicycle safety and is being used by all schools throughout the area. A number of sponsored bicycle rides have also been organised from this park.
Warilla
Ongoing breakfast program has been established at Warilla High School. Support to Roo Theatre to produce a play to adolescent audiences "Crying over You" with the theme of suicide prevention. A breakfast program has recently been established at Warilla North Community Centre.
Shellharbour
Has been the focus of many activities related to child injury prevention (see task force report on page 26 for further detail). These activities together with intersectoral collaboration and community participation contributed to a 17% reduction in children attending Shellharbour Hospital Accident and Emergency Department during 1990-92 (Booth et al, 1993).
Shellharbour and Kiama were the venues for the Take Away Food Accreditation Scheme now run by the respective councils.
Kiama
Ongoing assistance has been given to the Kiama Domestic Violence Committee. An educational pamphlet "Why Does Daddy Do It?" was launched at Warilla Women's Health Centre and widely distributed.
Healthy Cities also sponsored the first indigenous contribution to the Kiama Jazz Festival.
Currently we are involved with Kiama Council and others in the Kiama Municipal Health Plan which aims to bring the environment, economy and the community together for better health and better environment.
Jambe roo
Here Healthy Cities sponsored the first indigenous and ethnic contribution to the Jamberoo Folk Festival, the largest folk festival in NSW. These events are now a regular part of the Festival.
Community Sculpture at Berkeley
Needs Assessments and Evaluations 1991 - 1996
(a) Health Atlas of the Illawarra
This was published in 1991 and was undertaken by Tracey McDonald, a Masters student at Wollongong University and the Professor of Geography, Murray Wilson, with funding and support from Healthy Cities Illawarra. This Atlas besides using census data also interviewed people such as community nurses and gave details of general medical practice usage. The Atlas clearly showed the location and problems of those most disadvantaged and gave us a direction in which to go.
(b) Community Surveys
From time to time we have checked with the community in shopping centres, neighbourhood centres etc. as to the major problems facing the Illawarra. There has been some change in the community's perception to health issues, particularly increased concern about the environment. This process is ongoing and supplements information coming from task forces, Council of Reference and community projects and the many individuals who contact Healthy Cities for assistance.
(c) Forum for the Future
In 1993 Healthy Cities employed Phillipa Milne to facilitate and report on a workshop held with 50 people from the task forces, Council of Reference and interested others. This consultation confirmed that the environment, including clean air and water, transport, employment, Safe Communities and nutrition remained the top issues together with improving the health of Aboriginal people and overcoming discrimination against all disadvantaged people. As always the top issue was the environment. Phillipa's report helped to set directions for our strategic plan.
(d) Intersectoral and Community Participation
In 1993 we wrote to 33 government departments, organisations and community groups on our Council of Reference asking them if their commitment to the principles of Healthy Cities had increased in the five years since we were established and could they give examples of this commitment in their own organisation or community. All 33 replies stated that their commitment had increased and gave examples of how they had implemented these in their own community or organisation.
(e) Independent Audit of Healthy Cities Illawarra 1993
In 1993, the NSW Health Department requested an independent evaluation of Healthy Cities Illawarra. Phillipa Milne and Associates were commissioned to conduct the evaluation. The following is an extract from that report:
"Healthy Cities Illawarra (HCI) was first established in 1987 as one of a number of projects based on the WHO "Healthy Cities" concept. HCI receives an annual grant of around $100,000 from the NSW Health Department and has also attracted project funding from a number of other sources.
The principal goal of HCI is to improve the health status of the population of the Illawarra Area: its strategies are based on the five principles of the Ottawa Charter.
This audit was commissioned by the NSW Health Department to review the performance of HCI in 1991/92 and 1992/93 against the terms of its funding.
Achievements in relation to two funding agreements were reviewed and it was found that HCI had, in general, fulfilled the conditions of these agreements or was making satisfactory progress towards longer term goals. Activities reported in HCI quarterly and annual reports largely conformed with the performance indicators and evaluation requirements specified in those agreements.
That said, it should be noted that the funding agreements, particularly in 1991/92, were sufficiently open-ended to allow a huge diversity of different activities to be pursued while remaining within the terms of the agreement. Because of the process-oriented nature of some of the performance indicators and evaluation criteria, the effectiveness of these activities in achieving change is often difficult to judge.
The review of HCI activities has shown the major achievements of HCI to lie in:
• the ability to form successful working partnerships with other government and non-government organisations, achieving visible and positive results.
• achieving environmental improvements, particularly in disadvantaged areas. Notable examples include the Bellambi Environmental Improvement Program and Cringila Community Park.
• working with disadvantaged groups in practical ways aimed at improving opportunities for better health, e.g. food gardens.
• acting as a catalyst for change by adopting a co-ordinating, facilitating and support role in initiatives requiring diverse inputs and cross-sectoral co-operation."
(f) Other Reports, Evaluations, Surveys and Studies
Halloran, T, (1990), Healthy Cities Illawarra - A Report on the Pilot Project July 1987 - July 1990, University of Wollongong
Illawarra Regional Information Service, (1990), Healthy Cities Illawarra Project Review - Final Report July 1990, University of Wollongong
Worsley, T, (1990), National Evaluation of Healthy Cities Australia Pilot Project Australian Community Health Association, W Homer, Alexandria
Mangan, J and Pomfret, S, (1990), Import Usage and Escape Spending in the Illawarra , University of Wollongong
Chapman, D, (1991), Process Evaluation of Bellambi Breakfast Program University of Wollongong
Gill, B, (1992), Knowledge and Attitudes to AIDS in the Illawarra , University of Western Sydney, Campbelltown
Young, A & Laird P, (1992), Illawarra Environment 1992 - Air Quality and Transport Options , University of Wollongong
Bowyer, D, (1993), Main Meal Program Resource Manual, Illawarra Area Health Service
Wilkinson Murray Pty Ltd, (1993), Traffic Noise Study 1992, Healthy Cities Illawarra & Environment Protection Authority of NSW, Illawarra Area Health Service
Russell, C, (1993), The Take-Away Good Eating Program Evaluation Report, University of Wollongong
Environment Research Institute University of Wollongong (Laird P), (1995) Sustainable Transport for the Illawarra, Wollongong City Council
Nillsen, S, (1994), Report on the Environmental Impact Statement for Upgrading of Smelter and Refinery, Southern Copper Limited, Healthy Cities Illawarra
Nillsen, S, (1996), Report on the Application for Modification of Consent Conditions for Development Application 34/94 - Environmental Upgrade of Southern Copper Smelter, Port Kembla , Healthy Cities Illawarra
Working in Partnership - Healthy Cities Illawarra and the Illawarra Safe Communities Program
compiled by Ms Katherine van Weerdenburg, Dr David Jeffs and Ms Linda Brazier Illawarra Safe Communities Program
Introduction
According to the World Health Organisation (WHO)'s Health For All strategy (1981), "All human beings have an equal right to health and safety."
Emanating from this principle are two major WHO programs: the Global Program for Injury Reduction which promotes the "Safe Communities" model, summarised in the WHO Manifesto for Safe Communities (1989), and the WHO Healthy Cities concept, closely linked to the Ottawa Charter for Health Promotion (1986).
Although, philosophically and strategically, the Safe Communities concept shares much in common with the Healthy Cities approach, few Healthy Cities programs worldwide have specifically identified injury prevention as a major component of their activities. Moreover, only the Illawarra, and in 1996 Noarlunga in South Australia, have sought official WHO "Safe Communities" recognition.
Healthy Cities Illawarra has taken up the challenge to explore the potential of the Safe Communities concept. A workable partnership has been achieved in the Illawarra, capitalising on existing resources and introducing injury prevention to a well established program of community based initiatives.
Healthy Cities and Safe Communities Compared
The common ground between the two approaches is evident when comparing the Healthy Cities concept (in the terms of the Ottawa Charter) with the WHO Manifesto for Safe Communities (1989).
Healthy Cities Safe Communities Ottawa Charter 1986 Stockholm Manifesto 1989
Build healthy public policy Formulate public policy for safety
Create supportive environments Create supportive (safe) environments
Strengthen community action Strengthen community action
Develop personal skills
Reorientate health services Broaden public services
Both approaches recognise the importance of intersectoral collaboration and community participative approaches.
The identification of lifestyle and environmental issues which impact on the health and well-being of the community is central to the Healthy Cities brief. Given their common principles and shared philosophies, it is surprising that more Healthy Cities around the world have not tackled the issue of injury prevention in their communities, particularly since injuries are known to be one of the most significant public health issues facing the world's population today.
The rapid spread and success of the Healthy Cities concept has been well documented and hardly needs recounting in detail. When the WHO (Europe) Healthy Cities Planning Group met in January 1986, a 5-8 city project was envisaged. By mid 1990, this had grown to around 400 project cities actively involved in the movement (Tsouros (Ed), 1990). By December 1993, when the First Global Conference on Healthy Cities was held in San Francisco, over one thousand cities worldwide were believed to have adopted the Healthy Cities concept.
Opportunities therefore exist in many communities, where well established and well resourced Healthy Cities programs exist, to address injury prevention at a local level using the holistic Safe Communities approach.
This process is also a cost effective alternative. Healthy Cities Illawarra was able to attract extra funds to establish the Safe Communities program whilst broadening its issue base. At the same time, the Safe Communities program was able to access existing Healthy Cities resources (e.g., office space, administrative and professional support, stable funding base, community contacts, etc.) and was relieved of the financial burden of establishment costs. It made logical and financial sense to set up in partnership with Healthy Cities rather than separately.
As has been the experience in the Illawarra, promotion of the two concepts under the one umbrella is contributing to the creation of a community which is both safer and healthier.
The Illawarra
The region is situated on the South Coast of New South Wales, approximately 80 kilometres south of Sydney. The Illawarra Safe Communities Program comprises the three local government areas of Wollongong, Shellharbour and Kiama, and has an area population of approximately 240,000. The word "Illawarra" is aboriginal dialect meaning "where the mountains look down on the sea".
Although the region has a predominantly industrial profile, it also has a rapidly expanding University and tourism industry, and is renowned for its natural beauty with mountains, rainforest areas and long sweeping beaches.
The population of the region is characterised by diversity with almost a quarter of the population being overseas born and half of these (or 13%) from non-English speaking countries.
The Illawarra region was selected as one of three pilot Healthy Cities established in Australia in 1987, funded by the now Commonwealth Department of Human Services and Health.
Safe Communities - The Beginning
Child injury surveillance had commenced at four Illawarra hospital Accident and Emergency departments in November 1986. After accessing this data, Healthy Cities Illawarra was quick to recognise the need to address the significant child injury problem in the region. An intersectoral Child Injury Prevention Task Force was one of the original six task forces established by Healthy Cities Illawarra. Injury surveillance was also extended to "all ages, all injuries" at all four hospitals in 1992.
Intersectoral collaboration and community participation led to many successful child injury prevention programs. These ranged from a Safety in Schools project, to an extensive home safety and backyard injuries reduction campaign. These activities were felt to have contributed (in part) to a 17% reduction in children attending a local hospital Accident and Emergency Department during 1990-1992 (Booth et al, 1993) and reductions of more than 30% in school based injuries.
Following the success of Healthy Cities efforts in child injury prevention, further funding was obtained in 1992, from the Road Safety Bureau of the NSW Roads and Traffic Authority (RTA) to establish a "Safe Communities" program. In February 1994, the Illawarra was proclaimed a WHO Safe Community by the WHO Collaborating Centre on Community Safety Promotion.
Management of the Program
A Management Committee oversees the Illawarra Safe Communities Program by administering funds and providing support and direction. The committee consists of the Manager, Healthy Cities Illawarra; the Road Safety Manager, RTA Southern Region and the Director, Illawarra Public Health Unit. It meets bi-monthly with the project leader and there is also frequent informal contact.
The Council of Reference consists of 28 members who represent a range of public and private sector organisations including local government, secondary and tertiary education, BHP, public health, RTA, local Chamber of Commerce and emergency services. This provides the program's vital links to the community and its organisations. The council meets on a six-monthly basis to exchange information, review progress and be part of the planning process for our program.
The Illawarra Safe Communities Program takes an active role in, and helps to resource two major task groups:
Illawarra Road Safety Group Healthy Cities Illawarra Child Injury Prevention Task Force
In addition, Illawarra Safe Communities plays an important role in other intersectoral organisations, including the Safe Community Action Team (SCAT) - a Wollongong City Council crime prevention working party, and the Suicide Prevention Council.
Over the years, local injury data has been an important and useful tool to facilitate injury interventions. Unfortunately, injury surveillance processes have, at times, been unreliable; it is hoped that the recent conversion to a computerised system which includes an injury minimum data set, will provide more reliable information.
Working at Local, State, National and International Levels
The majority of the program's activity occurs at the local level. Here, contributions to the program are predominantly through direct involvement of local representatives, either in task forces, projects or campaigns or through the identification of hazards and safety problems. Participants include teachers, health workers, doctors, hoteliers, taxi drivers, preschools, parent groups, students, volunteers, residents' action groups, private businesses, disability groups, service clubs and many others.
In the Illawarra program, a very significant contribution is made by the local media, without whose support it would be difficult to spread the Safe Communities message through such a large geographically dispersed population.
The Illawarra Safe Communities Program and Healthy Cities Illawarra have liaised with local politicians who have, in turn, lobbied the State and Federal Governments on issues such as pool fencing laws, car occupant restraint legislation and funding support. The University of Wollongong, Faculty of Health and Behavioural Sciences, has also recently offered support for an injury research project and some curriculum development to incorporate aspects of injury prevention into a course on Health Promotion.
At a national level, links exist with organisations such as the National Injury Surveillance Unit, but most importantly, with other community based injury prevention programs across Australia.
A loose network of around 25 programs has, in 1996, given rise to the establishment of the Australian Injury Prevention Network with an interim executive being elected. The network aims to provide opportunities for information exchange between researchers, policy makers and practitioners from all sectors, encourage intersectoral and interdisciplinary collaboration and advocate for the implementation of appropriate injury prevention policies, legislation and programs.
The Illawarra has also played a role in promoting the safe communities concept internationally. The program has made representation and valuable contributions at a number of conferences including the 3rd International Conference on Safe Communities in Harstad, Norway in 1994 and the 5th International Conference on Safe
Communities in Victoria, Australia (1996). Notably, at the most recent conference, Professor Leif Svanstrom of the WHO Collaborating Centre for Injury Prevention acknowledged Australia as a world leader in the safe communities movement.
Following the 5th International Conference in Victoria the Illawarra hosted part of the 8th WHO Travelling Seminar. A group of delegates from countries including Croatia, Vietnam, Sweden, Thailand, Bangladesh, Zimbabwe and Kenya visited the region and experienced first hand some of the safe communities initiatives. The group visited the Lake Illawarra Road Safety Park, Mount Brown Public School to hear about the Student Committees for Injury Prevention (SCIP) Program and BHP for an Occupational Health and Safety presentation and plant inspection.
Recent Projects
Road Safety is an ongoing priority and specific projects have focussed on issues such as occupant restraint, and in particular the correct fitting and use of child restraints. Bicycle safety and road safety are combined at the Lake Illawarra Road Safety Park which was established after considerable lobbying by the Child Injury Prevention Task Force and the Safe Communities Program.
In 1995 a Safety Display Home was opened to the public. The project was a collaborative effort between Illawarra Safe Communities, Health Promotion and a private building contractor, Re-Lye-Able Homes. The house displays a number of safety design features both in its overall design as well as in its inclusions and has remained open to the public for over a year.
Through the Child Injury Prevention Task Force, the problem of dog bite injuries to children is being addressed with the development of a Stop-A-Bite campaign. The Illawarra Safe Communities Program has worked with local council officers, the RSPCA, vets and the private sector to develop a brochure and promote a video. Safe Communities has also lobbied strongly on the issue of gun control.
Conclusions
Healthy Cities Illawarra's strategic plan cites their mission as "to create a cleaner, greener, safer and more caring environment which is supportive of better health".
Through the Safe Communities program, injury prevention has been placed on the agenda of many local organisations, government departments and community groups, many of which had already well established links with Healthy Cities Illawarra.
Injury worldwide is a major health problem. For programs to be effective partnerships must be fostered with other organisations to bring about a culture of safety.
The Illawarra experience demonstrates the complementary nature of the Healthy Cities and Safe Communities approaches. Community networks and alliances established by a Healthy Cities program can be effectively used to introduce injury prevention initiatives which are relevant and responsive to local needs.
World Health Organisation Accreditation of Illawarra Safe Communities Program February 1994 ------References
Booth, D., Calvert, D., and Jeffs, D., (1993) "Local injury information, community participation, and injury reduction.", Australian Journal of Public Health, Vol. 17, No.4 , pp. 365-372, Dec 1993.
Tsouros, A.G.(Ed), (1990) "World Health Organisation Healthy Cities Project: A project becomes a movement", W.H.O. Healthy Cities Project Office, Copenhagen.
W.H.O. (1981) "Global Strategy for Health for All by the Year 2000", W.H.O. Geneva
W.H.O. Health and Welfare Canada, Canadian Public Health Association (1986) "Ottawa Charter for Health Promotion", W.H.O. Copenhagen
W.H.O. (1989) "Manifesto for Safe Communities", W.H.O. Stockholm
Conclusion
There are still substantial community health issues ahead for the Illawarra and Healthy Cities Illawarra must continue to work strongly and supportively for a better and healthier Illawarra. The next ten years should be just as exciting and interesting as the past ten. We look forward to facing this challenge with the community.
With the resignation of Brian Stewart in 1996 and Tony Mills in 1997, Healthy Cities Illawarra lost two very talented people who gave firm direction to the project as well as sharing a strong commitment to human rights and the needs of those most disadvantaged.
We welcome our new Manager, Frank Wallner and our Assistant Manager Linda Brazier who also share those qualities.
We are currently conducting a community survey of our perceived achievements, weaknesses and future directions which will help us chart our course for the future.
As part of our ten year anniversary, we are presenting awards to individuals and organisations who have contributed most in a voluntary capacity in various categories to our community. We are also running a competition for a Healthy Cities poster exemplifying the principles we stand for.
We are now totally a non-government organisation, the change to which has produced a number of changes and necessary re-organisation. We thank the NSW Department of Health and the Illawarra Area Health Service for their past help and look forward to a continuing and fruitful relationship.
While it has sometimes been difficult to see the way ahead clearly it is a journey we could not have undertaken without the help, guidance and assistance of the whole Illawarra community. Visitors to the area have often commented on the cohesion, sense of pride in and the beauty of the Illawarra and its multicultural people. We hope we have played some part in this process.
Healthy Cities Illawarra Incorporated Management Committee
Present Members: Dr Pat Mowbray President Mr David Muscio Vice President Councillor May Hudson Treasurer Mr Frank Wallner Secretary/Public Officer Councillor Joyce Wheatley Councillor Dragi Bogoevski Dr Victoria Westley-Wise Ms Colleen Martin Ms Jan Woodward Ms Sue Kirby Ms Jill Coleman Ms Angela Tobin
Past Members: Professor Dennis Calvert Dr David Jeffs Professor Christine Ewan Mr Tom Halloran Professor Jim Falk Mr John Curry Councillor David Campbell Mr Tom Hadley Councillor Kerrie Christian Mr Geoff Robinson Councillor Ken Langstaff Ms Cecily Stead Councillor David Young Ms Jane Wilson
Staff of Healthy Cities Illawarra Incorporated
Present Staff: Mr Frank Wallner Manager Ms Linda Brazier Assistant Manager Ms Penny Lumb Healthy Cities Shoalhaven Project Leader Ms Robyn Langlands AIDS Task Force Project Officer Ms Barbara Boniface Office Manager Ms Karen Jones Administrative Officer Ms Bronwyn Hobbs Finance Officer
Past Staff: Mr Brian Stewart Manager 1987-1996 Mr Tony Mills Manager 1996-1997 Assistant Manager 1990-96 Ms Joanne Keane Community Food Garden, Shoalhaven Mr Alfred Wellington Community Food Garden, Shoalhaven Ms Alison Geary Community Food Garden, Wollongong Ms Karin Allen Administrative Assistant Ms Geraldine Davies Domestic Violence Project Officer Ms Diane Bowyer Main Meal Project Officer Ms Cathryn Russell Take Away Food Project Officer Ms Karen Simpson Finance Officer
Staff of Illawarra Safe Communities Program (all staff funded by Roads and Traffic Authority) Present Staff: Ms Melinda Griffiths Project Leader Ms Wendy Cook-Burrows Project Officer Ms Katherine van Weerdenburg Project Officer
Past Staff: Ms Katherine van Weerdenburg Project Leader Ms Linda Brazier Project Leader Ms Dianne Taylor Project Officer